LIBRARY OF CONGRESS. 

®(fap. - icpgriglji 1a 

Shelf.X-i'6 



UNITED STATE8 OF AMERICA. 



NERVOUS EXHAUSTION: 

ITS CAUSE AND CURE. 



COMPRISING 



A Series of Bistit Lectures on Debility and Disease, 

AS DELIVERED NIGHTLT AT 

Dr. Kahn's Museum of Anatomy, 



PRACTICAL INFORMATION ON MARRIAGE, ITS 
OBLIGATIONS AND IMPEDIMENTS. 

ILLUSTRATED WITH CASES. 

INCLUDING PICTURES FROM REAL LIFE, OR 
PHOTOGRAPHIC LIFE STUDIES, 

ADDRESSED TO THE YOUNG, THE OLD, THE GRAY 
THE GAY. 



By DR. L. J. 



KAHN, 



LECTURER ON ANATOMY, PHYSIOLOGY, AND SCIENCE ; AUTHOR OF 

M THE LUNGS IN HEALTH AND IN DISEASE '" MEDICAL 

ESSAYS AND REVIEWS, ETC., ETC. 



ffo, 51 EA ST TENTH STREET, bet. University Place & Broadway, 
JfEW YORK, 



a. 



Entered according to Act of Congress, in the year 1870, by 

Dr. L. J. KAHN, 

In the Clerk's Office of the District Court of the United States for the 

Southern District of New York. 



CONTENTS. 



PAGE. 

Preface 5 

LECTURE I. 

The Anatomy and Physiology of the Urinary and 
Generative Organs , 9 

LECTURE II. 
Physiology of Marriage 18 

LECTURE III. 
Onanism, or Self-pollntion 30 

LECTURE IV. 

Of Nocturnal Emissions, Seminal Weakness, Im- 
potence, Sterility, and Nervous Exhaustion. . . 53 

LECTURE V. 

The Moral and Physical Effects of Self-abuse, Sper- 
matorrhea, Impotence 80 

Modern Treatment of Spermatorrhoea, Seminal 
Weakness . and Nervous Debility 89 

On Certain Urethral Discharges 95 



IV CONTENTS- 

LECTURE VI. 

PAGE, 

Vene* eal Disease : — History 96 

Diseases of Infection — Gonorrhoea, or Clap 103 

Gleet 106 

Stricture 108 

Syphilis, or Pox. 10 r J 

Secondary Symptoms; Effects of Mercury, &c 113 

LECTURE VII. 

Certain Means by which a Correct Knowledge of 
the Patient's Case may be Obtained 116 

LECTURE VIIL 
On Skin Diseases 120 

APPENDIX. 
Selections from my Case-Book 129 

PICTURES FROM REAL LIFE. 

Picture First : The Young Sensualist 172 

Picture Second : The Bachelor Sensualist 177 

Picture Third : The Married Sensualist 180 

Picture Fourth : The Widower Sensualist 183 

Picture Fifth : The Sceptic Sensualist 187 

Picture Sixth : The Promiscuous Sensualist 191 

To Patients and Invalid Readers 195 



PREFACE. 



The following chapters have been written for 
the purpose of imparting some little information 
on subjects of the greatest importance. The 
frightful ravages of Spermatorrhoea, and the 
dire effects of Syphilis, are matters which must 
almost alarm the calm impartial observer. If 
anything can therefore be done to stay the 
mighty torrent, he who, having the means at 
his command, should neglect to do it would be 
criminal. The cause of humanity — of religion 
— demands assistance from all who are in a 
position to give it. Feeling this, I have done 
w T hat I could. 

The following pages are pre-eminently prac- 
tical: I am no theorist. To offer theory when 
assistance is required is very like giving a stone 
in answer to a request for bread. Speculation 
we have enough of — hypothesis we are nearly 
surfeited with — what we want is something that 
can be put into practice. I have related my 
own medical experience, and narrated cases 
that have come under my own observation. 



6 PREFACE. 

This may seem egotistical, but it is the only- 
true method of procedure. Why should I de- 
vote my book to what occurred to others ? I 
know nothing of it, except by hearsay. What 
I have seen, that I speak of, because that I 
know. Nor have I succumbed to that false 
prudery which is so prevalent in society: Lhave 
disregarded it because I believe it to be mis- 
chievous and to have no connection with real, 
genuine modesty. I have told plain facts, and 
those who affect to be shocked at them will only 
remind me of the young lady whose modesty 
was so great that she could not look at the 
naked truth. My aim is a good one : if men 
misinterpret my motive I cannot help it, nor do 
I care for what they may say. 

But it is now quite unnecessary to make any 
apology for publishing a book of this nature. 
The importance of the subject on which it 
treats has long been recognized by the Pulpit 
and by the Press, by the learned and by the 
unlearned, by the Medical Profession, and by 
their patients. I do not hesitate to assert that 
the lessons taught by this little book will prove 
of the greatest value to all who study them in 
a proper spirit. The laws of the Creator are 
absolute and unchanging ; it is impossible to 



PREFACE. 7 

do evil or to violate those laws without ill effects 
resulting. Health is essential to happiness ; 
and to enjoy health we must study the unchang- 
ing laws which govern it, and they are not 
difficult to understand. Years of experience 
have proved that many of the most fatal dis- 
eases to which man is subject arise from unre- 
strained passions and vicious indulgences. "The 
solitary vice of Self-pollution, " says Dr. Wood- 
ward, "spreads desolation through the land." 
When we see the miserable victims of an in- 
sidious and unsuspected disease slowly but 
steadily emaciating ; when we view a series of 
phenomena faintly and indistinctly character- 
istic of a great variety of disorders, such as 
consumption, wasting away, loss of energy, 
physical and mental, and actual brain disease, 
can we surrender without remorse — secundum 
artem, as it were — the unhappy sufferer to his 
fate ? Shall we not rather, despite false deli- 
cacy, investigate the origin and causes of such 
diseases, and endeavor to determine the true 
principles of their cure ? To these investiga- 
tions the microscope has proved an invaluable 
assistance, and the most important recent dis- 
coveries are due to its aid. The discovery of 
the §permatozq4 and their existence in the 



8 PREFACE, 

spermatic fluid of all animals, proved that their 
presence was essential to reproduction. Hence 
a microscopic examination of urethral dis- 
charges, or of the urine, furnishes means for a 
correct diagnosis of some of the most obscure 
cases of spermatorrhoea and impotence. The 
author takes this opportunity of tendering his 
thanks to his numerous friends, patients, and 
to the public generally, for the favor with which 
his previous works on the subject have been re- 
ceived. I have endeavored in this treatise to 
give the result of my mature experience in lan- 
guage simple and free from technicalities. If 
I am successful in warning one who would have 
fallen of the fearful consequences of vice ; of 
restoring one to hope who had otherwise been 
hopeless, this work has not been written in 
vain. In conclusion, I may observe that those 
who wish to apply for advice or assistance may 
confidently do so without hesitation or diffi- 
dence ; as the most timid may rely on my in- 
variably regarding that inviolable secrecy which 
has already proved the basis of an extensive 
and respectable professional reputation. 

L. J. Kahst, M.D. 

M East Tenth Steeet, New York, 



NERVOUS EXHAUSTION. 



LECTUKE I. 

THE ANATOMY AND PHYSIOLOGY OF THE URIN- 
AKY AND GENERATIVE ORGANS. 

In these days of general education, every man 
ought to possess a certain knowledge of the com- 
position of his frame, the science known as 
Anatomy ; * and also the mode that nature 
adopts to carry out the necessities of life, that is 
Physiology. The present work being devoted 
to the consideration of special maladies, their 
causes, prevention, and treatment, it will be 
sufficient for our object to give a brief and 
popular description of the generative organs, 
in order that the nature of the diseases may be 
fully understood. We are indeed "fearfully 

* "Anatomy is the science of organization. Physio- 
logy is the science of life." — Richkrand. 



10 KEEVotis Ex&Aumosf. 

and wonderfully made ;" the great importance 
of the generative organs, and their preservation 
in a state of health and vigor, are essential to 
well-being, both physical and mental. Their 
admirable construction, form, and use are a 
striking evidence of skill and contrivance di- 
rected to the performance of that most im- 
portant function, the reproduction of the species. 
The generative organs in man may be divided 
into external and internal ; the former consist- 
ing of the testicles and penis, and the latter of 
the seminal vessels, the urethra, the prostate 
gland, &c, with their arteries, veins, nerves, and 
lymphatics. The urinary organs consist of the 
kidneys, ureters, bladder, and urethra. The 
kidneys (renes) are two glands, in shape rep- 
resenting a kidney bean, lying close upon 
the muscles of the loins, behind and below the 
stomach. It is supposed these organs are larger 
in persons of strong sexual passions than in 
those who are less addicted to venery. 

The Ureters are long tubes, connecting the 
kidneys with the bladder, to which they convey 
the urine secreted by the kidneys. 

The Bladder is situated in the lowest part of 
the body, or pelvis; it is a muscular bag or 
pouch, and consists of at least three coats or 



XERVOUS EXHAUSTION. 



U 



coverings. One being composed of muscular 
fibres, its contraction causes the expulsion of 
the urine. At the neck of the bladder is a 
muscle called the sphincter, by which the in- 
voluntary flowing away of the urine is prevented. 
The chemical composition of urine, in health, 
according to recent analysis, is as follows : — 
( Vide Liebig. ) 

I. 
Urea 
Uric acid 
Coloring matter 
Odorous principles 
Kreatine 
Lactic acid 
Hippuric acid 



Separated from the blood 
by the kidneys. 



Developed more directly 
from the food. 

II. 



Sulphates 
Phosphates 
Chloride of sodium 
Soluble salts 

Debris of epithe- 
lium 
Phosphate of lime 
Mucus of the blad- 
der 



Saline combinations de- 
rived from the food. 



Common to all fluids pass- 
ing over mucous sur- 
faces. 



12 NERVOUS EXHAUSTION. 

We direct attention more particularly to this 
table, as many diseases, in fact nearly all, change 
in some respect the composition of the urine; 
and careful analysis enables the medical man 
to arrive at a correct diagnosis at an early stage 
of the malady, when any mischief may be easi- 
ly remedied. In unhealthy urine some one or 
other of these substances may be in excess, or 
may be altogether wanting. The elements may 
be combined in a manner altogether different ; 
or some substance may be eliminated from the 
blood and prove a source of considerable danger 
to life itself. We have not sufficient space to 
enlarge on this subject ; we will merely refer 
to one or two of the most serious of these 
diseases. In Diabetes, not only is there an 
inmoderate flow of urine, but it is found to 
contain a large amount of sugar — so much in- 
deed as to be perceptibly sweet to the taste. Un- 
less attended to at an early stage, this disease 
is generally fatal. We have saved many valu- 
able lives by attending to the indications shown 
by the urine at a stage when the disease was 
not suspected. Others we have warned, and 
not in vain, though at the time it was difficult 
to convince them. One more illustration of the 
value of these inquiries. There is a decidedly 



NEBVOUS EXHAUSTION. 13 

marked change in the chemical composition of 
the urine when a stone is forming in the blad- 
der. For some time previously, a state of health 
is indicated which the judicious administration 
in remedies may remove, and thus prevent the 
necessity of a serious and painful operation. 
We may here remark, that an accurate analysis 
of the urine is one of the most difficult processes 
in chemistry, and can only be performed, with 
any approach to correctness, by one who is well 
versed and constantly engaged in minute in- 
vestigations of this kind. It requires, also, one 
who has acquired a thorough knowledge of the 
microscope, the value of which cannot be over- 
rated. For many years the author has availed 
himself of this valuable adjunct to diagnosis, 
with a success which his attentive practice will 



The testicles (testes) are two glands enclosed 
in the scrotum, or purse; they are composed of 
a vast number of fine tubes, folded in various 
directions, and enclosed by a membrane called 
the tunica albuginea. The testicles secrete the 
semen, and are supplied with blood from the 
vessels which arise from the main arterial trunk, 
called the spermatic arteries. The importance 
which men attach to the due performance of 



14 NERVOUS EXHAUSTION. 

the function of these organs is evident from the 
number of the suicides caused by their imper- 
fection. The testicles are sometimes three in 
number, and occasionally there is only one, 
though many of the latter cases prove, on exami- 
nation, to be a retention of the testicle in the 
abdominal canal. A young man who had been 
ordered a truss for a supposed rupture, consulted 
us; we found the case was simply one of reten- . 
tion of the testicle. Had the truss been applied, 
he might have been lamed for life. 

Tlie Seminal Canals (Vasa Deferentia), which 
ascend on each side from the upper part of the 
testicle, accompany the spermatic artery, vein, 
and nerves, and are together called the Spermatic 
Cord. The seminal bladders (vesiculas) are at 
the upper part of the bladder, and are considered 
to be the reservoirs for the semen. They also 
secrete a peculiar fluid, which is added to the 
semen in the act of coition. The prostate gland 
is in front of the seminal bladder; in shape and 
size it somewhat resembles a chestnut. The 
fluid which it secretes is of a cream color, and 
serves to lubricate the surface of the urethra, 
along which the semen has to pass. The prostate 
gland is subject to disease and relaxation, and 
when this is the case the act of copulation is 



XEEVOUS EXHAUSTION. 15 

unsatisfactory and even painful. We have 
frequently been consulted in cases where there 
has been a continuous discharge from this gland; 
the semen is then emitted by the slightest 
effort, more especially during sleep; this has 
often been the cause of wasting away, strophy, 
or consumption. Many surgeon3 have treated 
these cases as venerial, and their inexperience 
has proved most injurious. The microscope 
here lends its valuable aid. The penis is divided 
into the root, the body and the glands. The 
spongy substance which forms the glans penis 
is covered with a thin membrane, under which 
are placed very sensitive nervous papilla, which 
are the chief cause of the pleasure in coition. 
Many in the venerial act have not the glands 
distended, which arises from a weakened state 
of the cavernous body of the urethra. When 
this is the case from Onanism, or other causes, 
impotence will arise; which, unless its cause be 
perfectly understood, cannot be cured by any 
physician. 

The glans is protected by the prepuce, or 
foreskin. In healthy men, at the moment be- 
fore the semen is ejected, the glans and whole 
body of the penis are extremely rigid; soon after 
a convulsive motion follows, the semen is dig- 



16 KEEVOTTS EXHAUSTION. / 

J 

charged by a reflex action, and there is a slight 
loss of strength throughout the body, which 
however soon recovers tone. But the erection 
of the penis may also be produced by mechani- 
cal irritation, as friction of the glans of the 
prepuce, caused by a distended bladder, as 
evinced in the morning after a night's rest, 
also by tumors or stone in the bladder. This 
highly complicated and delicate organism, of 
which we have given a brief outline, is entirely 
subservient to the proper secretion and ejection 
of the Semen. 

The semen is a thick whitish fluid, with a pe- 
culiar odoriferous smell; it consists of the 
liquor seminis and certain solid particles. The 
liquor seminis is colorless, transparent, and 
albuminous, and contains, floating in it, two 
principal constituents, viz., spermatozoa and 
seminal granules. The microscope must here 
be called into requisition. The spermatozoa 
are living bodies or animalcula, existing in very 
considerable numbers in healthy semen. They 
are also found in the urine, but never excepting 
the generative organs have become weakened 
by Onanism or excesses. 

The animalcula are formed like a tadpole, 
with a round head or body, and a narrow tail; 



KERVOITS EXHAUSTION. 17 

they move with great rapidity, and their length 
is about a six-hundreth to a thousandth part of 
an inch. 

Wagner has shown that they are developed 
within cells, and originate from the spermatic 
granules, being formed by the dispersion of the 
nuclei of these cells. Their original discovery 
is due to Lowenhoeck, in 1667. The animalcula 
are not found in the fluid contained in the 
seminal organs before puberty, but they are 
always present afterwards; nor do they disap- 
pear while the power of procreation is retained. 
But when the semen is diseased by the debility 
of the parts, their number becomes fewer, until 
at last they almost disappear. There is no doubt 
that the animalcula are essential for the im- 
pregnation of the ovum in the female, but all 
our ingenuity and research have been vainly 
exerted in the attempt to unravel the mysterious 
process of conception. Life and organization 
are neither inseparable nor even identical. Man 
is still ignorant how life begins or ceases. We 
must turn to the Creator of all things, and 
though we can explain the structure, the primal 
cause is beyond all human reason. 



LECTURE IL 

PHYSIOLOGY OF MARRIAGE. 

The sacred ordinance of marriage emanates 
from the Deity, by whom we are enjoined to 
"increase and multiply/' — hence it is consider- 
ed honorable amongst all men, and should not 
be entered upon carelessly or wantonly, nor 
without duly considering the causes for which 
it was originally ordained. Marriage was intro- 
duced by the Divine Creator, in the time of man's 
primitive innocence, as the means of his happi- 
ness and the perpetuation of his race. Its in- 
fluence extends from individuals to kingdoms, 
and to the whole world. Jeremy Taylor calls 
it "the mother of the world, which preserves 
cities, and fills cities, churches, and even heaven 
itself." It is the primitive source of morals 
and society, the nurse of virtue and patriotism, 
the stay and support of governments. In a word, 
no other social institution exercises so profound 
an influence on the well-being of society. The 
obligations of marriage are mutual and impera- 
tive; if any deception is practised, those culpable 
will sooner or later receive punishment in the 
disappointment of their pleasure, the loss of their 



NERVOUS EXHAUSTION. 19 

health, and the remorse of their own reflections. 
It unfortunately happens — in the present arti- 
ficial state of society — that many men are unable 
to marry before middle life, perhaps after a youth 
spent in more or less dissipation — perhaps after 
having acquired the seeds of disease and impo- 
tence. The question then arises — Is such a man 
capable of procreating healthy children, or of 
satisfying those desires inplanted by nature in 
the most modest and virtuous of women, not less 
strongly than in man himself? The conscious- 
ness of deficiency must cause any man to feel 
abashed, and he can oSer no excuse but what 
must tend to lessen the love and respect of his 
wife. Ignorance — of a density unequalled, of an 
obstinacy unparelieled — long prevailed on the 
topics which control most completely the fitness 
of men and women for wedlock. There are 
certain stages of injured health, capable, by 
early and skilful treatment, of thorough and 
speedy cure; but which, if neglected, or in- 
judiciously dealt with, render aught but disgust 
and misery in marriage a thing humanly impos- 
sible. Xo man is so likely to be jealous as the one 
that is conscious that his wife has just reason for 
complaint; and no woman is so likely to go astray 
as one who is tantalized by the abortive toying 



20 NERVOUS EXHAUSTION. 

of an impotent husband. We admit nothing can 
justify a wife in proving false to the marriage 
vow, and nothing can ever after restore her to 
the position of a virtuous woman; but cases fre- 
quently occur where much might be urged in 
extenuation, and where he who is considered the 
injured husband is in reality more guilty than his 
wife. Women were formed to completerthe well- 
being of man, and those who abstain from inter- 
course with them are rarely either happy or 
healthy. Marriage constitutes the bond of so- 
ciety, and the respect paid to its ordinances 
affords the best test of the moral condition of 
a civilized people; but where generative weak- 
ness exists, let not the unhappy sufferer augment 
his own misery by the sacrifice of one from 
whom he can expect nothing but dislike, re- 
proaches and contempt, and whose happiness may 
thus be marred. It may be safely affirmed, that 
a difference of temperament between married 
persons is conducive not only to mutual affec- 
tion but to fertility. Nature appears to desire 
marriages between different families and nations, 
because such crossings of the various races im- 
prove and invigorate the species. Humboldt 
and others have observed that the offspring of 
Europeans and Ethiopeans are peculiarly robust 



KEKVOUS EXHAUSTION. 21 

and active. From numerous observations of a 
similar nature, he argues that the best mode of 
eradicating hereditary diseases, gout, scrofula, 
consumption, epilepsy, madness, etc., in their 
early tendency, is by the commixture of the spe- 
cies in intermarriage, which often prevents the 
transmission of disease to the next generation. 
The mental weakness, as well as mean appear- 
ance, of some of the European royal families is 
strongly cofirmatory of the truth of these prin- 
ciples. Walker, in his admirable and interesting 
work " On Intermarriage," proves beyond the 
possibility of cavil, that insanity, idiocy, and 
numerous physical ailments occur four times 
above the average in the offspring of "family 
marriages. v When persisted in for some genera- 
tions, the race usually becomes extinct. Nor is 
this confined to man alone — the rule extends 
from man downwards, through the whole realm 
of animated nature. 

The essentials of reproduction on the male 
side are a healthy condition of the whole gen- 
erative system: the erection of the penis should 
be perfect, maintenant and .vigorous, and the 
secretion and emission of the semen obedient 
to the command. On the part of the female, 
the generative organs should be sensible of the 



22 NERVOUS EXHAUSTION. 

approaching impulse; the best test of their 
healthy state is the presence of desire, and the 
enjoyment of the orgasm simultaneously with 
the male. Instances of generative incapacity, 
local weakness, and utter impotence are very 
numerous. Again, it is no uncommon circum- 
stance for a man on his approach to a female, 
with a view to sexual commerce, though he 
may possess all the confidence necessary, to find 
the tone of his inclination suddenly leave him, 
and to observe a seminal discharge almost im- 
mediately on contact, or even before; the de- 
sign is, of course, frustrated, at least for some 
time, and he has to endure the double mortifi- 
cation of incurring and giving disappointment. 
Another frequent deficiency is an insuficiently 
lasting erection, which prevents the mechanical 
irritation requisite to excite the proper action 
of the seminal vessels. Other persons possess 
both desire and capability, but at very consider- 
able intervals — a sure sign of approaching decay. 
Occasionly, from disease, or from want of exer- 
cising the generative functions, men may be 
found where the organization is perfect (though 
the development is rather smaller than usual), 
yet where there is a total inaptitude, or, at all 
events, a complete distaste for sexual intercourse. 



ffERVOUS MHAtJSTlOK. 23 

SucH cases are curable without much difficulty. 
In the early stages of seminal weakness, differ- 
ent persons are variously affected; some are in- 
capable of procuring a discharge of the semen 
into the cavity of the female genitals in a 
natural way, though they may effect temporary 
erection; while others cannot perform the act of 
copulation, from emission taking place too 
quickly, and before the proper firmness of the 
male organ has enabled it to effect the requisite 
penetration. What man, possessing the ordi- 
nary feelings of a man, can contemplate with- 
out a shudder these terrible consequences of 
self -indulgence? The nuptial bed of such an one, 
instead of teeming with a hallowed, ecstatic and 
transporting delight, is converted into a scene 
of blended mortification, disgust, disappoint- 
ment, and suppressed anger; and it is now that 
the mistaken bride is made to feel herself the 
victim of previous sensuality — the poor, deceiv- 
ed, last hope of vigor — anxious for offspring, 
yet baffled from day to day in the arms of the 
man she has vowed at the altar to love and 
honor; and he, conscious of the cause of his 
infirmity, the dark secret smouldering in his 
breast, galling his wretched existence, and not 
to be imparted even to the wife of his bosom. 



M HEltVOtTS EXHAUSTION. 

A gentleman recently wrote to us in the follow- 
ing powerful language: — "Dear Sir, — You are 
the first to whom I have plucked up resolution 
to open my case; I fear it is beyond even your 
skill, but, for heaven's sake, give it your careful 
consideration, and above all, let me have your 
candid opinion; I shall then know how to act. 
My age is 25; I have practised self -pollution, 
when a boy, some years, indeed to a very recent 
period. I married a beautiful young woman 
three months ago. I experienced an excitement 
most powerful, my passion was most vehement, 
and I attempted the sexual act. Immediately 
a spontaneous emission occurred, the excitement 
left me, and my emotions and desires became 
palsied. My system became utterly incompetent 
to manly or vigorous health. That is the history 
of my first attempt, and of every succeeding trial. 
If you can assist me I shall be grateful for life. 
My wife bears with me with angelic patience, but 
I cannot long endure my present wretchedness. " 
In a letter a few months later, this gentleman 
writes: — "My Dear Sir, — Words fail to express 
my gratitude for your skill and kindness. I am 
happy to inform you that my dear wife is now 
enceinte. This I am aware will not surprise 
you; but I cannot forbear writing to express 



NEBYOUS EXHAUSTION. 25 

my gratitude. My dear wife also desires to be 
most kindly remembered/' 

That the happiness of married life may in a 
great measure be secured or defeated by atten- 
tion to, or neglect of, what lies in our power 
previous to its consummation, is as true as that 
there are duties obligatory alike upon man and 
wife after marriage. If a man has made a hasty 
or thoughtless selection, the fault is assuredly 
his own. Although it cannot be doubted that 
warm and mutual affection is an essential con- 
dition to married felicity, it must be remember- 
ed that passion is a false and treacherous guide, 
when not founded on well-merited and well- 
defined respect. It is often inquired, what is 
the proper age to enter the marriage state ? and 
the question is one that is difficult to answer. 
Much depends upon individual health and tem- 
perament; but as a general rule, we find the 
happiest unions, and also the most fruitful, 
when the man marries from the age of twenty- 
five to thirty-five, and the woman is from five 
to seven years younger. Dr. Samuel Johnson 
observes : * ' Those who marry at an advanced age 
will probably escape the encroachment of their 
children; but, in diminution of this advantage, 
they are likely to leave them, ignorant and help- 



26 NERVOUS EXHAUSTION. 

less, to a guardian's mercy; or, if that should 
not happen, they must at least go out of the 
world before they see those they love best either 
wise or great." It is quite certain that on young 
women marriage will frequently have a most 
beneficial effect. Hysteria, Nervousness, Irregu- 
laritiy, sometimes even Consumption, are known 
to disappear after marriage. In reference also 
to the male sex, it is quite certain that, in- 
depently of many morbid affections and habits 
which marriage removes, it augments the energy 
of the system of the blood vessels; the distended 
arteries, pulsating with greater force, transmit 
warmth and animation throughout the body; 
the muscles become more vigorous, the step 
more elastic, the voice firmer, every physical 
attribute of humanity becomes boldly developed. 
Marriage, however, is not altogether made up 
of " sighs and wreathed smiles;" though it has 
its devotions, it has also its obligations; and the 
divine command, "increase and multiply," can 
only be obeyed by those in the full possession of 
mental and bodily vigor. Even under the most 
favorable circumstances of youth and vigor, it 
is necessary to warn the newly-married couple 
of the danger of excessive indulgence, which 
injures thQ health of WQmen, and by causing 



NEBVOUS EXHAUSTION. 27 

many painful diseases, soon renders intercourse 
utterly repugnant. It also prevents or impairs 
the offspring — for whatever enfeebles or diseases 
the sexual organs must of necessity have that 
effect. Temperance in the connubial embrace, 
as in all other things, is the medium which we 
should observe and recommend. The following 
case will illustrate some of the dangers to which 
we have referred: — W. S. called upon us for 
consultation early in June, 1862. His age was 
about twenty-five, and his occupation salesman 
in a dry-goods house. He had been always very 
regular in his habits, had. never been guilty of 
Onanism, nor of illicit connection. His frame 
was rather delicate, and his temperament nerv- 
ous-sanguine. About ten months previously he 
had married a young widow, and for about six 
months he indulged very freely in the pleasure 
of the marriage-bed, without feeling any bad 
effects. About that time, however, he began to 
lose flesh very perceptibly, and to feel great 
lassitude on the least exertion. His appetite 
failed — his sleep became disturbed and unre- 
freshing — his bowels constipated; in short, all the 
symptoms proved a general failure of health. 
Added to this, his sight became impaired, and 
also his memory — he lost energy and spirit, and 



28 HEBVOUS EXHAUSTION. 

his daily occupation was a trouble to him. He 
now began to complain of pain in the upper 
part of the right lung, and considerable diffi- 
culty in breathing; and soon began to spit blood, 
of bright red color and frothy appearance. Be- 
coming seriously alarmed, and suspecting that 
his illness was caused by excessive indulgence, 
he called upon us for advice. On examining his 
chest, I observed some dullness on percussion 
in the upper portion of the right lung, imme- 
diately under the clavicle; the respiratory mur- 
mur was also absent from this part — in other 
respects the lungs seemed all right. The action 
of the heart was somewhat irregular, being very 
much hurried from a slight cause. Of course, 
it was essentially necessary that he should ab- 
stain from all sexual intercourse; medicine was 
prescribed suitable for the case, and within a 
month he began to recover strength — the pul- 
monary symptoms gradually declined, and per- 
cussion elicited the natural healthy sound over 
the chest. He was under treatment some six 
or seven weeks, and he promises that the lesson 
shall not be thrown away. 

We earnestly advice all who contemplate en- 
tering the marriage state to take advice from a 
thoroughly qualified practitioner, as to whether 



KEEYOUS EXHAUSTION. 29 

there is anything to be set right before the mar- 
riage is consummated. Much misery, perchance 
innocent lives may be spared by attending to 
this obvious and easy duty. Sometimes an old 
venerial contamination maybe lingering in the 
blood. Careful examination and analysis will 
decide; and treatment for two or three weeks 
may prevent long years of unhappiness. 

In concluding this part of my subject, I may 
be allowed to observe that it is right and useful 
that all men should know that there are prin- 
ciples of personal management which cannot be 
violated without the incurral of grievous penal- 
ties; it is right that they should know, when 
wisdom and regret succeed the heyday of incon- 
siderate self-indulgence, how these penalties 
may be mitigated, and how the sting of their 
remorse may be ultimately removed. The most 
absurd of all emotions is that of despair. Let 
the sufferer remember that there is scarcely any 
degree of weakness or functional derangement 
to which the timely aid of science cannot apply 
a cure. 



LECTURE III. 

ONANISM, OR SELF-POLLUTION. 

Manustrapsio, Masturbation, the Sin of Onan, 
are the names commonly given to this pernicious 
habit, which may be defined a discharge of the 
semen by the stimulus of the virile organ with the 
hand; the habit (it is said) of the solitary monk 
and recluse, as well as of inconsiderate youth, 
and too often of those whose riper years should 
prevent their guilty indulgence in an act so re- 
volting to humanity, and so destructive to every 
sentiment and feeling of vigorous manhood. 
If we refer to the opinions expressed by the 
most celebrated physicians amongst the ancients 
or moderns, we find a remarkable uniformity 
in their opinions on this subject. Celsus remarks, 
"These habits are always hurtful, and indulgence 
in them weakens the strongest constitution. " 
Galen gives a corresponding account of the evils 
caused by thi3 vice. The late Mr. Benjamin 
Bell, the eminent surgeon, of Edinburgh, also, 
in reference to the effects of this indulgence, 
says, — "A habit so baneful to many of our 
youth, that I believe it to be more destructive 
in its effects than a greater proportion of all the 



NEBVOUS EXHAUSTION. 31 

diseases to which in early life they are liable." 
Besides rendering the patient himself miserable, 
it evidently entails the severest distress upon 
posterity by generating languor, debility and 
disease, instead of that strength of constitution, 
without which there can be no enjoyment. 
Lallemand remarks, — "Our lunatic asylums 
afford many instances of insanity produced by 
this detestable practice. " Nocturnal pollutions, 
or "wet dreams" are in most causes brought 
on by Onanism. After a short period has 
elapsed, the nocturnal are now conjoined with 
diurnal pollutions; the semen passes off in the 
urine, or at stool, without sensation, and there- 
fore unmarked by the patient. It therefore be- 
comes a problem of the greatest interest and 
importance, if there be any means by which the 
presence of spermatozoa, or the living principle 
of the seed, may be detected with certainty. "We 
have introduced into our practice the use of the 
microscope, which for the purpose of diagnosis 
is absolutely indispensable. By the examination 
of a small quantity of the matter or discharge 
from the urethra, or by the microscopic observa- 
tion of the urine we are enabled to decide with 
certainty as to the presence or absence of the 
seminal fluid, and, consequently, on the neces- 



32 NERY0US EXHAUSTION. 

sary treatment required by the case. A gentle- 
man called upon us in September, 1866, aged 
27. He stated he had been induced to consult 
us, owing to having observed some yellow-color- 
ed stain upon his linen. He had been treated 
for nearly a month for gonorrhoea; but finding 
himself get worse instead of better, had called 
for our opinion. We carefully examined the 
discharge, and also the urine, by means of the 
microscope, and immediately detected a great 
loss of semen in the urine, and that the matter 
consisted almost entirely of the seminal fluid. 
On inquiry he admitted, though with great 
reluctance, that he had been in the habit of 
practising Onanism. A proper course of medi- 
cine was administered, and in four or five weeks 
he was entirely well. 

It frequently occurs, as a result of self -pollu- 
tion, more especially when practised in early 
youth, that the testicles do not attain their full 
size and powers of secreting semen. This state 
has been termed "an arrest of development " a 
phrase which simply means that the organs have 
ceased to grow at a period of life previous to 
puberty. We have seen the case of a gentle- 
man, aged 28, whose penis and testicles were 
not larger than those of a boy ten years old. 



NERVOUS EXHATTSTIOX. 33 

Other cases of a similar character have also 
presented themselves to our notice. Such in- 
stances are not beyond the influence of medicine, 
unless when they occur in the persons of idiots. 
Wasting or diminution in the size and powers 
of the organs may occur at any age. The 
testicle may retain its proper shape though 
diminished in size; it feels soft to the touch, 
and loses its elasticity and firmness. In texture 
it is pale, and the blood-vessels seem diminished 
in number, the spermatic cord becomes affected 
by the disease, the nerves shrink, and the 
cremaster muscle disappears. The thin gelatin- 
ous semen which is formed is entirely devoid of 
spermatic granules and spermatozoa. In other 
words, its fertilizing power is lost, and impuis- 
sance gradually results. When disease is the 
cause of the atrophy, the testicles may alter in 
shape — become uneven and irregular — some- 
times elongated as well as diminished in size and 
weight. There is one form of disease which 
frequently precedes the decay of the organs, and 
which is seldom observed by medical men — a 
low inflammation, quite painless, acts upon the 
testicle, and gradually increases the bulk, at the 
same time diminishing the firmness and consis- 
tency; in some instances the testicle almost feels 



34 NERVOUS EXHAUSTION. 

as if dividing. On inquiring into the origin of 
these cases, we frequently find that a swelled 
testicle (hernia humoralis) has existed, caused 
by gonorrhoea. Hence the necessity of curing 
urethral discharges as rapidly as possible, and 
the care required in the use of astringent in- 
jections. Injuries of the head, more especially 
the back part of the head, have been known to 
produce decay of the testicle; and this fact may 
tend to support the theory of the phrenologist 
that the seat of amatory passions is in the cere- 
bellum. Doubtless the brain exercises great in- 
fluence on the desire for sexual intercourse, and 
it is equally certain that there is a reciprocal 
action of the generative organs upon the brain. 
Such is the similarity of structure of the brain 
and the testicle, and so great the sympathy be- 
tween them, that an extensive experience during 
many years has proved that in some instances 
a species of derangement is caused by diseases 
of the generative organs. It is chiefly on the 
youth of both sexes that self -pollution commits 
most ravages. This is so much more to be deplor- 
ed, as it thus strikes at the very root of society, 
and has a direct and immediate tendency to des- 
troy it, by enervating and debilitating, almost 
from their very cradle, those whom nature's 



StEBYOUS EXHAUSTION. 35 

God intended as best adapted to preserve and 
adorn it. How many of the debilitated and ema- 
ciated objects daily present themselves to our 
view, with pallid and haggard countenances and 
sunken eyes, who are indebted solely to the 
abominable act of masturbation for this wretched 
state of debility and exhaustion ? Disabled from 
rendering service either to themselves or friends, 
they drag on a life totally useless to others 
and a burden to themselves, in the midst of 
society in which they are despised. A frequent 
cause of the practice of Onanism is igxoraxce 
of the enormity of the crime, a crime, of which 
an eminent divine has written: — "In itself it is 
monstrous and unnatural — in its practice filthy 
and odious to extremity — its guilt is crying and 
its consequences ruinous — it destroys all con- 
jugal affection — prevents natural inclination — 
and tends to extinguish the hopes of posterity. n 
There are thousands among the youth of both 
sexes — ingenuous, docile, diligent, and tractable 
— who, either from example or from accident, 
have thus learned this vice, who would have 
abhorred the thought, had they understood the 
nature of the sin, and been made acquainted 
with its fearful results. As connected with this 
subject; we may here observe that anything like 



36 NERVOUS EXHAUSTION. 

attempted concealment respecting it is a practi- 
cal injury to morality. The Book of books it- 
self is not only standing evidence of the heinous- 
ness of "the sin of Er and Onan" but of the 
necessity of proclaiming it to all mankind. Their 
sin was committed in the full consciousness of 
its inherent hatefulness, and therefore their 
punishment was most signal. Their example has 
been left on record as a fearful warning to 
future generations; as a measure of the de- 
pravity of certain transgressions, and the inevit- 
able certainty of retributive justice. Another 
cause of self -pollution is the secrecy with which 
it maybe committed; all other actions of un- 
cleanliness must have a witness, this needs none. 
Again, the laws against adultery, though in many 
cases inoperative, are sufficient to deter many; 
whereas in self -pollution neither the cautious 
nor the covetous imagine they have anything 
to fear. How strange it is that a man should 
show bashfulness and the utmost cowardice to 
his fellow-creature (even should that fellow- 
creature be the most impotent wretch) and that 
he should behave with gigantic boldness and 
impudence to the Almighty Creator of heaven 
and earth. The most experienced medical practi- 
tioners are of opinion that the development of 



NERVOUS EXHAUSTION. 37 

the neryous system, and the predominance of its 
action oyer the other parts of the organism, are 
also amongst the causes of masturbation. We 
comparatively seldom see this habit indulged in 
by robust and vigorous persons, whose muscular 
and digestive organs are in full development; 
they are generally more disposed to exercise their 
limbs, as well as their appetite for the pleasure 
of the table, in which their minds are too much 
engaged to allow them to addict themselves to 
indulgences in other gratifications. This ex- 
cessive development of nervous sensibility, which 
is the source of so many praiseworthy actions, 
as well as of so many vicious enormities, and 
which, according to the directions it receives, 
gives rise to the most splendid or to the 
basest of results, may be derived either from 
natural disposition or from early education. It 
is immediately after early infancy, at that epoch 
when the faculties of the new being commence 
to be developed with energy, that he runs the 
greatest danger. If then an unfortunate accident, 
or, as too frequently happens, the indelicate 
touches of strange hands, disclose to the young 
subject what may at this time be considered a 
new sense, there takes place at this period to- 
wards the genital organs a greater or less codl- 



38 NERVOUS EXHAUSTION. 

centration of the vital forces, and the patient, 
led on by the delusive pleasure, gives himself up 
with fury to a vice which is sure soon to destroy 
him, or draw down on him evils more terrible 
than death itself. Another most dangerous pe- 
riod of life is the approach of puberty, which 
varies in this climate from the age of eighteen 
to twenty-two. The rapid growth of the genera- 
tive organs — the increased power and frequency 
of erection — the rapid secretion of semen — all 
lead to the performance of that act which is 
sure to occasion the deepest remorse. It is the 
attentive consideration of these varied facts 
which explains to us how the habitual exercise 
of the genital organs, either by coition or mastur- 
bation, may so far get the better of the will of the 
individual as to force him to indulge in practices, 
the object of which is to gratify the venerial stim- 
ulus. In almost all such cases the shameful act 
when finished, is invariably followed by bitter 
regret; but as the organs obtain repose, the 
resolution which he had adopted, of relinquish- 
ing the baneful practice, and which he had 
thought nothing could shake, are soon for- 
gotten. We have frequently heard patients ex- 
claim: "Oh! how often and often have I solemn- 
ly sworn never again to pollute myself, and how 



NERVOUS EXHAUSTION. 39 

often have I promised myself, when in the act, 
that it should be for the last time." We implore 
those who have addicted themselves to this 
ruinous and suicidal habit not to rely on their 
own resolution — not to depend on their own firm- 
ness and fancied strength of mind; let them ap- 
peal to Higher Aid — and, above all, let them 
prayerfully avoid temptation. 

If we compare the injurious effect of exces- 
sive indulgence in coition and those of mastur- 
bation, we shall find that the causes which com- 
bine to render excess in the former dangerous 
act with much more energy in the second, and 
that several circumstances peculiar to the latter 
render the results of its frequent repetition more 
serious. It is well known that the man who ad- 
dicts himself to the solitary and debasing prac- 
tice of Onanism is kept for a considerable time 
in a state of general and permanent rigidity of 
the entire body; this state of tension is sometimes 
carried so far that very painful cramps are caused 
by it, and the fatigue which results obliges the 
patient to relax his efforts occassionaly to take 
rest. It is sufficient to observe the circumstances 
which accompany masturbation to see that the 
nervous system must be directly affected by it, 
not only from the violent and continued con- 



40 NERVOUS EXHAUSTION. 

tractions which it occasions throughout the en- 
tire muscular system, but also by the prodigious 
tension of the imagination, which is in cases 
wound up to its highest state, in order to repre- 
sent to the devoted votaries of self -pollution the 
fantastical object of their disgusting transports. 
Another cause which renders Onanism more 
dangerous than excessive indulgence in coition 
arises from the circumstance that it is much 
easier to addict one's self to the one than to 
abuse the other; for when a man gives himself 
up to the natural pleasures of love, the fatigue 
felt, as well by his companion as by himself, will 
have the effect of preventing his exhaustion; 
whilst on the other hand there is no bridle, no 
restraint on him who practises self-abuse; the 
former is in general obliged to wait for a favor- 
able moment and opportunity to indulge in his 
excess — every momeni answers the purpose of 
the latter — all he requires is mere solitude. He 
constantly carries about him the sting which 
torments him; he alternately finds his imagina- 
tion exciting his organs, and his organs inflam- 
ing his imagination. In short, there is nothing 
to distract or take up the attention of one who 
has addicted himself to Onanism, whilst a 
thousand circumstances are constantly distract- 



NERVOUS EXHAUSTION. 41 

ing the attention of the man who is disposed for 
the enjoyment of a female. Another serious 
danger in this vice is the period of life when 
persons addict themselves to it; we have occa- 
sionally met with it in quite young children, most 
frequently amongst full-grown boys and young 
men, for the various difficulties and impediments 
which prevent copulation before a certain age 
do not exist in the case of Onanism — thus the 
generative propensity, called forth prematurely, 
and gratified viciously, steps in amidst all the 
natural efforts of growth, with its unnatural 
train of moral excitations, sensual shocks, and 
physical pollutions. No wonder that the Father 
of Medicine should notice its effects, thus iEtius 
gives the following description : ' ' Young people 
have the air and appearance of old age ; they 
become pale, effeminate, lazy, benumbed, stupid 
and imbecile; they have a total distaste for every- 
thing, are totally incapacitated, and may even 
become paralytic." In short, when we look upon 
the horrible consequences resulting from this 
practice, are we not justified in regarding it as 
a lingering moral and physical suicide ? 

As we have intimated, the practice of Onanism, 
when once indulged in, is difficult to abandon; 
the patient is perhaps for years unconscious of any 



42 NERVOUS EXHAUSTION. 

change, and no one part of the body feels weak- 
ened more than another; but there gradually 
comes over a creeping languor, a want of energy, 
a sensation of lassitude, a depression of spirits, 
ennui, and a disinclination for society; these 
feelings at length increase so as to attract the 
attention of the patient and his friends. He 
and they are sensible that he is not what he 
formerly was; his face becomes pallid, the circles 
around the eyes depressed and darkened, a thin- 
ness is visible in his looks, his hands are fre- 
quently cold and clammy, he cannot bear the 
cold he was wont to do, his old pursuits have 
no attractions for him, nor do any new ones 
attract his attention; his memory becomes im- 
perfect, his vision is not so clear, nor his sight so 
strong, as formerly; morbid sensations annoy 
him; at length he sinks into fatuity, and either 
is carried off by some rapid decline, or hastens 
his end by laying violent hands on himself. 
Such is the history of many cases of suicide of 
which we read in the newspapers. The follow- 
ing, illustrating many of the above features, is 
from the work of the celebrated French physi- 
cian, Tissot: — 

" , by profession a watchmaker, had 

been brought up morally, and, until the age of 



NERVOUS EXHAUSTION. 43 

sixteen had enjoyed a state of perfect health; 
about this period the evil example of a youthful 
companion initiated him in the habit of self- 
abuse, which he repeated daily, eyen to the ex- 
tent of two or three times, and until the seminal 
emission was followed by a slight insensibility, 
and a complete prostration of mental and bodily 
strength; this warning was insufficient to rescue 
him from his disgusting practices; and the repe- 
tition of them became more frequent, till he was 
in a state which gaye reason to apprehend a fatal 
termination. Too late a penitent, he had become 
incurable, and the generative organs were so 
weakened that the slightest irritation caused a 
partial erection, with an immediate emission of 
seed, which of course increased his weakness, and, 
becoming incapacitated, he was obliged to re- 
linquish his business. Thus, oyerwhelmed with 
misery and disgrace, he pined for some months 
without assistance, with the agonizing reflection 
that he himself was the cause of his awful situa- 
tion. I was called upon to attend him, and found 
him past recovery; he was meagre, pale, and al- 
most incapable of moving; a palish watery matter 
issued from his nose, and a continued frothing 
from the mouth; he was affected with diarrhoea, 
and voided his excrement in bed, without being 



44 NERVOUS EXHAUSTION. 

conscious of it; he had a continued discharge of 
semen; his eyes were fixed and watery, and his 
pulse low, rapid, and at times almost imper- 
ceptibfe; it was with much difficulty he breath- 
ed, and he was reduced nearly to a skeleton. His 
mind was equally disordered, his memory was 
lost, incapable of forming or connecting his ideas 
— in short, without reflection or any sensation 
but pain ; he was reduced far below the brute crea- 
tion, and presented a spectacle hardly possible 
to describe. I immediately administered tonic 
medicine in conjunction with anti-spasmodics, 
without the slightest hope of affording more 
than a little temporary relief , and haying effected 
this, I declined attempting to remedy further 
what was past any human aid. He gradually 
sunk, and for a few days prior to his dissolution, 
which took place in the middle of August, he 
lay in a state of unconsciousness, and was utterly 
incapable of taking the least nourishment/' 

Thanks to the exertions of Medical Science, 
aided by the researches of many skilful physi- 
cians, who have devoted their lives to the in- 
vestigation of these diseases (amongst others I 
may be allowed to record my late lamented teach- 
er and friend, Lallemand, as the most scientific 
and keenest observer, the most successful in 



KERVors EXHAUSTION. 45 

practice, and, finally, the most benevolent) — 
thanks to the important discoveries in chemistry 
and to the light thrown on the cause of disease 
by the use of the microscope, we have nof often 
presented to us cases so desperate as the above. 
Indeed, during my long experience and ex- 
tensive practice, I may assert, without hesita- 
tion, that no one patient has left my charge 
without having derived immense benefit from 
my treatment: and many cases, apparently hope- 
less, where my patients have been far gone in 
consumption, where the vital energy has been 
reduced to the lowest ebb, where generative de- 
bility and impuissance have existed for years, 
have been restored, under Providence, by my 
remedies to health, strength and manhood. 

Still it is difficult to depict a more truly miser- 
able being than the slave to licentiousness. His 
imagination burning with filthy, unnatural 
glow; his bodily organs taxed to the utmost, 
weary and jaded, refuse to obey the stimulus 
of that never-slumbering depravity which goads 
his fancy in the darkness of night, in the dreams 
of his broken rest, and in the worse than dreamy 
abstractions of the cheerless day ; he is tormented 
with desires he can never gratify, shut out from 
those enjoyments accorded only to virtuous 



46 KERVOtTS EXHAtTSTIOK. 

moderation; the blossoms of youth (perhaps the 
flower of manhood) the supremacy of mind, all 
degraded, obliterated, gone ! Let not the in- 
tensely prurient, yet seeming modest victim of 
self-pollution lay the flattering unction to his 
soul that from the eye of his fellow-mortals he 
can conceal his unmanly practices. It is written 
upon his forehead; the physiognomy, that faith- 
ful mirror of the soul and body, gives clear indi- 
cation of the internal disorder. The complexion 
and plumpness which jointly confer a youthful 
look, and which is the sole substitute for beauty 
— f or without this even beauty produces no other 
effect than cold admiration — this complexion and 
plumpness are the things that first disappear; a 
leanness succeeds; the skin becomes rough, often 
of leaden tinge; the eyes lose their brilliancy, 
and by their languor express that of the whole 
frame; the lips lose their vermillion hue, the teeth 
their whiteness, the hair falls off, and it is no 
uncommon thing for the whole body to become 
bent and distorted. Abashed, the sufferer shrinks 
from the gaze of his fellow-man, fancying sus- 
picion in the eye of every one who looks upon 
his sunken, haggard, pale, unmeaning, inex- 
pressive face; his dull, lack-lustre eye; his thin 
and tremulous form, which all hetray him to the 



NERVOUS EXHAUSTION. 47 

practised observer. For self-pollution en- 
tails upon its victim marks as legible, to 
the eye that can understand them, as the 
scars of small-pox; and thus proves a striking 
fulfilment of the prophetic warning — "There is 
nothing done in secret that shall not be reveal- 
ed/' nor hidden, even from the recognition of 
mortals, that shall not ultimately be made, even 
to them, evident as noon-day. Shall we not 
therefore raise our testimony against these vices ? 
Sir Astley Cooper justly remarks in one of his 
lectures: u If one of these miserable cases could 
be depicted from the pulpit as an illustration 
of the bad effects of a vicious and intemperate 
course of life, it would, I think, strike the mind 
with more terror than all the preaching in the 
world. The irritable state of the patient leads 
to the destruction of life, and in this way, an- 
nually great numbers perish. Undoubtedly, the 
list is considerably augmented from maltreat- 
ment, and the employment of injudicious reme- 
dies." And the late learned Dr. Pereira, whose 
abilities as a practical physician were only 
equalled by his acquired learning and innate 
knowledge of human nature, observes, in review- 
ing "Nervous Exhaustion/' — "There is a 
vast deal of injury done, not merely to public 



48 NERVOUS EXHAUSTION. 

morals, but to the individual health, by the 
abuses and excesses of the reproductive func- 
tions; the primitive fathers and physicians have 
duly noticed the evils to which I allude, and 
every experienced medical practitioner can attest 
their frequent occurrence. It is all very well for 
sentimentalists and the mock-modest to declaim 
about the notice of them; but justice, morality, 
and the preservation of health, as well as the 
perpetuation of the human race, demand it. 
Such, however is the hyprocrisy of the day, that 
even a notice in a dead language is abused and 
condemned by the ignorant and intolerant, who 
are unable to appreciate the importance of the 
subject. This is a bold step in the right direction. v 
ISTor are the evils of self -pollution confined to 
the male sex only. That it rages with deathly 
virulence among young women, especially among 
young ladies in the higher circles of society, is 
a matter of notoriety. Dr. Fowler writes, — 
"That women, young and apparently modest, 
are dying by thousands of consumption, of fe- 
male complaints, of nervous or spinal com- 
plaints, of general debility, and of other osten- 
sible complaints innumerable, and some of in- 
sanity, caused solely by this practice/' In con- 
firmation of this, Mrs. Gore, in her " Lectures 



XERV0US EXHAUSTION. 49 

to Ladies on Anatomy and Physiology," re- 
marks, — ,,Some years since, my mind was 
awakened to examine this subject by the perusal 
of a medical work that described the bad effects 
of this vice (masturbation) when practised by 
females. This was the first intimation I had 
that the vice existed among our sex; since that 
time I have had much evidence that it is fear- 
fully common among them. Were this the 
particular vice of the low and vulgar, there 
might be more excuse for the apathy and false 
delicacy that pervades the community respecting 
it; tut it invades all ranks — professed Christians 
are among its victims. Our boarding and day 
schools are sources of intolerable mischief." 
Mrs. Gore is one of those ladies who, throwing 
aside conventionality, have studied anatomy and 
medicine; she passed one of the colleges in the 
United States, and now enjoys an extensive prac- 
tice, as well as much reputation for skill, in 
Boston, Mass. On this subject her testimony is 
of value, and we do not scruple to make use of it. 
The effect of self -pollution in the male is similar 
in the female; the results common to both are 
impotency in the one, and sterility or barrenness 
in the other. We observe amongst them much 
tendency to histerical complaints. Consumption 



50 NERVOUS EXHAUSTION. 

numbers amongst its victims many young and 
fair, who have first brought on its seed by self- 
abuse. The glairy discharge, so common and 
so weakening, and which is generally termed 
the "Whites," is another frequent result of this 
error. We do not mean to assert that in every 
instance this discharge is thus caused. I have 
known many instances where it has been caused 
by excessive intercourse with the husband; but 
when it occurs amongs unmarried women of a 
certain age, self pollution, though not the in- 
variable cause, is one of the most prominent 
and predisposing. But enough on this very 
painful subject — we probe the wound deeply 
that we may the sooner heal it. Should this fall 
into the hands of one who has sinned, let her re- 
member that science and skill may do much to 
restore to health and happiness — let her repent, 
and pray that "she sin no more." 

Many individuals scarcely turned forty years 
of age, and sometimes even earlier, who have 
lived rather freely, are not unfrequently about, 
that period of life greatly changed in their poivers 
of sexual intercourse. They may, indeed, in 
general health and personal appearance, be stout, 
and for several years not very sensible of the 
degeneration of their powers, but the frequency 



KEHVOTJS EXHAUSTION. 51 

of their inclination for such duties gradually 
becomes much diminished, and that is a symp- 
tom which is at all times indicative of approach- 
ing impotence; for the inclination gradually and 
entirely ceasing, the power speedily follows, or 
rather both are lost together. In others, about 
the same time of life, the physical power ceases 
first, and the inclination continuing, often for 
many years after, they are oliged to gratify 
themselves in amusements which are the mere 
pantomime of amorous indulgences I Such in- 
dividuals, being otherwise in tolerable health, 
are recoverable. 

Many who have unwarily acquired the habit 
of self -pollution have been convinced, by read- 
ing this treatise, of its iniquity and injurious 
consequences to health, and have determined to 
give it up, thinking that by so doing they may 
recover their pristine health and vigor. In this, 
however, they are deceived. A new and un- 
natural association having been established be- 
tween the organs of generation and the mind, 
the bad consequences of the practice do not 
cease when the habit is left off. Involuntary 
discharges of semen take place during sleep, 
occurring as frequently as two or three times 
in the course of one night. The effect of these 



52 HERVOUS EXHAUSTION. 

emissions is extremely debilitating ; all the 
symptoms already described are aggravated, and 
the mind sinks into a state of the deepest de- 
jection. Here there is no time to lose; they 
should immediately apply for the necessary 
medicine, and the practice being discontinued 
(certainly a main point in the case) they may 
confidently anticipate the speedy renovation of 
their constitution. I therefore recommend an 
early application for advice and assistance, 
which in every case will be given with that kind 
consideration and undeviated attention that will 
give confidence to the timid, and restore vigor 
to the debilitated. 



LECTURE IV. 

OF NOCTURNAL EMISSIONS, SEMINAL WEAK- 
NESS, IMPOTENCE, STERILITY, AND 
NERVOUS EXHAUSTION. 

The secretory glands of the human body form 
an apparatus, the action of which is unvarying 
and constant. The liver is perpetually employ- 
ed in the formation of bile; the kidneys, in the 
separation of urine from the blood. In fact, all 
the secretions are derivable from the living and 
vitalizing fluid. The gall-bladder is provided 
as the temporary receptacle for the bilious 
soapy fluid secreted by the liver; and as the wants 
of the system require, it is poured into the first 
intestine to assist in the separation of the 
nutritive portion of the partially digested ali- 
ment. Precisely analogous is the action of the 
testicles, pouring their appropriate secretion 
into the receptacles described in the anatomical 
section of this work, and denominated the "vesi- 
culce seminales, or seed-bladders" not to be ab- 
sorbed again into the system, but rather to be 
excreted as indispensable to the reproductive act. 
Hence the stimulus arising from distention of 
these vessels becomes a pleasurable impulse to the 



54 KERVOUS EXHAUSTION. 

necessary multiplication of the species; and if 
sexual desire were susceptible of gratification 
only as the result of instinct; if depraved man, 
instead of lashing his genital organs to exertion 
by filthy conversation, lewd and impure imagina- 
tions, and the various causes which are entirely 
absent among the brute creation; if, like them, he 
were content to follow the dictates of his unerring 
organization, diseases from excess would be un- 
known, equally among us as with them; and their 
proverbial and almost certain fecundity be but 
the transcript of our own. As the seminal vessels 
(like the gall-bladder) will not allow of extra- 
ordinary distention the thinner portions of the 
semen become 'partially absorbed; and though 
thereby the bulk of that secretion be lessened, 
yet the residuum becoming more acrid and stimu- 
lating, the impulse to excretion is thus rendered 
unconquerable; and so nature (in the absence of 
the act to which the stimulating impulse tends) 
occasionally relieves herself of the superabundant 
secretion. Of this act, men are mostly un- 
conscious; if, however, it arrest attention, its 
frequency and its consequences are the circum- 
stances that rouse the proper and natural fears 
of the sufferer. 

A popular author on this subject observed,— 



NERVOUS EXHAUSTION. 55 

" The causes of these nightly or *wet dreams,' as 
they are called, are numerous. In the first place, 
the testicles must have acquired, through the 
practice of Onanism, (for involuntary emissions 
rarely assume the formidable character here de- 
picted, except induced by masturbation), a 
morbid sensitiveness, that, on the slightest local 
or neighboring irritation, they put in action their 
secretive powers. In fact, the infirmity might 
not inaptly be termed a consumption of those 
glands. Consequently, the causes may be, at this 
period, piles or hemorrhoids, constipation, in- 
digestion, irritability of the bladder, or kidneys, 
&c, &c. ; for they all, more or less are present, 
and, perhaps, severally aggravated by stimuli, 
of one kind or other, taken during the day or 
previously to rest. Another occasion may be the 
loss of tone of the absorbents, and also loss of 
the sensibility of the passages through which the 
discharge escapes; thereby acting as somnolent 
sentinels only to the brain, whereby even the 
little control the will might possess is lost! So 
by this we perceive that this infirmity is not 
merely local debility of the generative apparatus, 
but that many other functions of life participate 
in it. The constant drain from the testicles im- 
poverishes the whole system, and the same phe- 



5() HERV0US EXHAUSTION. 

nomena ensue as when Onanism is practised to 
the same extent. The semen of a person torment- 
ed with this infirmity is thin, watery, sickly 
odored and rarely prolific. Although I have al- 
ready depicted the consequences of unnatural 
indulgences in the previous pages, the following 
passage, from a more able pen than my own, 
exhibits so well the desolating effects alluded to, 
that its transcript is too useful to my purpose to 
neglect: — "The muscles of the youth become 
soft; he is idle; his body becomes bent; his gait 
is sluggish, and he is scarcely able to support 
himself. The digestion becomes enfeebled, the 
breath fetid] the intestires inactive; the ex- 
crements hardened in the rectum, and producing 
additional irritation of the seminal conduits in 
its vicinity. The circulation being no longer free, 
the youth sighs often, the complexion is livid, 
and the skin, on the forehead especially, is 
studded with pimples. The corners of the 
mouth are lengthened, the nose becomes sharp; 
the sunken eyes, deprived of brilliancy, and en- 
closed in blue circles, are cast down; no look of 
gayety remains — the very aspect is criminal. 
General sensibility becomes excessive, producing 
tears without a cause; perception is weakened, 
and memory almost destrojed. Distraction, ox 



SnEBYOUS EXHAUSTION. 57 

absence of mind, renders the judgment unfit 
for any operation. The imagination gives 
birth only to fantasies and fears without 
grounds ; the slighest allusion to the dominat- 
ing passion produces a motion of the muscles 
of the face, the flush of shame, or a state of 
despair. The wretched being finishes by shun- 
ning the face of men, and dreading the obser- 
vation of women. His character is entirely 
corrupted, or his mind is totally stupefied. 
Involuntary loss of the reproductive liquid 
takes place during the night, and also during 
the daily motions ; and there ensues a total 
exhaustion, bringing on heaviness of the head, 
singing in the ears, and frequent faintings, 
together with pains, convulsive tremblings, 
and partial paralysis/' 

The reproductive potver may not he entirely 
destroyed ~by that state of generative debility 
which is engendered ~by nocturnal emissions 3 
and yet very painful consequences of another 
character may unquestionably arise. A healthy 
female may become pregnant, from the feeble 
yet exhausting effort of a man whose constitu- 
tional power is seriously broken, yet it would 
be unfair, unphilosophical, unsupported by 
any analogy drawn from the history of the 



58 KERVOUS EXHATTSTIOtf. 

lower animals, to expect that this circumstance 
would not tell most powerfully and detrimen- 
tally upon the offspring. The opinions of the 
learned, in all ages, haye not varied widely on 
this subject. Lucretius, and a great number 
of ancient physiologists, admitted this doctrine. 
That great man considered that there was a 
mixture of fluids, and that these, united in 
the sexual organs of the female, were animated, 
developed, and changed into a being resembling 
those who furnished them. Further, that the 
most vigorous of the two determined the sex; 
and if this principle be admitted, it is easy to 
trace every puny or diseased peculiarity the 
father or mother may transmit. It appears to 
be the general opinion that whichever parent 
furnishes the most elaborate, the ?)iost abundant 
seminal fluid would impress the lineaments and 
form upon the offspring; that the most vigorous 
parent who would possess most genital power, 
would determine the sex and physical character of 
the infant; and consequently that the offspring 
would most certainly resemble this parent, 
both in mind and body. If genital power be 
equal, the child may be expected to resemble 
both. But this can scarcely be expected, 
where there is debility of the generative organs 



NERVOUS EXHAUSTION. 59 

in- either parent, and the elaboration of im- 
perfect fluids, from their too frequent escape. 

Of Seminal Weakness. — The prominent 
character of Seminal Weakness is general, not 
partial, debility. The seminal vessels are fitted 
to perform certain functions with progressive 
regularity, which, if undisturbed by disease, 
or unimpaired by vicious perversion of the : 
natural sexual habit, they will continue to exe- 
cute through the whole range of the years of 
active manhood. Sexual ability in man is a 
mysteriously compound power, requiring a 
perfect association in the action of the secret- 
ory organ of the seminal secretion, and the 
instrument of its ejaculation and discharge. 
Any functional irregularity, or want of corres- 
pondency between the action of the testicles 
and penis, is therefore an unquestionable state 
of disease; for since both are so closely and 
intimately dependent on each other, the least 
want of exactness in their adaptation might 
be the cause of Impotence, Whatever be the 
mode in which this deviation from the healthy 
and natural action of the parts is first induced, 
it is not difficult to trace its inevitable effect 
in the production of Seminal Debility and the 
ultimate destruction of sexual power. Irrita- 



60 NERVOUS EXHAUSTION. 

tion, however engendered, rapidly propagates 
itself along the urethra; and chronic inflam- 
mation of the prostatic and most sensitive 
portion of that canal is rapidly established,, 
and the muscles surrounding the membranous 
division of the urinary passage are sympatheti- 
cally affected with irregular spasm. The 
irritation extends itself by continuity of sur- 
face to the seminal vesicles, and even to the 
testicles, producing in the former unnatural 
evacuations, and in the latter an exaggerated 
thin secretion, too rapidly elaborated, and 
therefore, for all the purposes of generation, 
worthless. 

Among individuals so affected (on attempt- 
ing intercourse with the sex) the emission is too 
quickly discharged, nocturual pollutions are 
frequent (indeed these are often the immediate 
precursors of seminal weakness) or the semen is 
expelled during the evacuation of the Madder 
and lowels. With some, there is more or less 
complete extinction of venereal desire, the 
erections become few and feeble, incomplete, 
or absolutely impossible. This condition of 
the sexual organs has its appropriate general 
character, analogous to those which are attribu- 
table to the wilful and determinate pollutions 



NERVOUS EXHAUSTION. 61 

of earlier youth ; the sufferer, now perhaps 
too late, sensibly alive to the origin of his 
weakness, becomes timid, fearful, careless of 
the world around him, his mind absorbed in 
the consideration of his malady, until the 
continual presence and recurrence of the same 
train of painful thought involve him in the 
worst form of monomania, or rather the pre- 
mature childishness of old age. All the func- 
tions of the body languish and are deranged, 
until a complete and general degredation sweeps 
with uncontrolled dominion over every power 
and faculty, both of body and soul. The semi- 
nal fluid may dribble away without pleasure, 
without erections, without the natural ejaculation 
and its loss, when occurring in this manner, 
gives rise to the same or infinitely greater evils 
than those which occur from mere sexual excess, 
or what is worse, from self pollution. 

The term Impotence is applied as relative to 
that inability or incapacity to the performance 
of the sexual act, which may arise from a va- 
riety of causes, but from none so frequently as 
the excesses of Sensualism, more especially the 
secret, vicious, and solitary indulgences of self- 
pollution. It is important, in a practical point 
of view, that we do not confound this condition 



62 NERVOUS EXHAUSTION. 

of the generative system with Sterility, inas- 
much as a male who is sterile, or a barren 
female, may possess a perfect aptitude for coi- 
tion, though for all the purposes of procreation 
absolutely incapable. In Impotence there is a 
temporary or permanent destruction of those 
powers which are absolutely essential for gen- 
erative purposes. Sterility may therefore be 
defined as inability to propagate the species, 
though not to affect the sexual congress; while 
Impotency in either sex, whether natural or ac- 
quired, whether as the result of disease or mal- 
formation, entirely precludes its performance. 
Impotence, resulting from physical imperfec- 
tion of the sexual organs, is mostly incurable; 
but when originating in such disorders of the 
urinary or genital apparatus as are traceable to 
irritation or inflammation of those structures, 
or to conditions however produced, thence re- 
sulting, such as thickening of the bladder, en- 
largement of the prostate glands or testicles, 
wasting of the penis, especially long-continued 
gleets and strictures, our first efforts are natu- 
rally directed to the removal of those proximate 
causes of Impotence; and if the habit be still 
indulged, the baneful, ultimate, or primary 
cause of so severe a deprivation. If } under those 



XERTOrs EXHAUSTION. 63 

circumstances, Nature do not readily reassume 
her wonted functions, if there be remaining de- 
bility, it is necessary to invigorate the frame by 
the employment, not merely of those diffusable 
stimuli which act generally upon the whole sys- 
tem, but by the administration of remedies 
which are known to act immediately upon the 
generative organs. If there be present excessive 
irritability, it is necessary to employ such reme- 
dies as tend to diminish irritation in the mor- 
bidly sensitive organs. 

The causes of Impotence in man arise from 
two sources — from vicious malformation of the 
genitals, or from want of power; but among 
women, Impotence can only depend on malfor- 
mation, either natural or acquired. These 
causes are more commonly observed in man 
than in the other sex, and this is easily ac- 
counted for by the greater part the male has to 
perform in the nuptial congress. This is evi- 
dent from the phenomena which gave the virile 
member the form and disposition proper for 
erection, the introduction of the organ, and the 
ejaculation of the semen, which are effected by 
a violent and complicated action, requiring a . 
concurrence of many indispensable conditions, 
the organs not only contracting spasmodically ' 



84 . KEHVOUS EXHAUSTION. 

to effect the expulsion of the male fluid, but all 
the body participating at this moment in a 
strange convulsion, as though nature at the in- 
stant forgot every other function. It will be 
obvious that the treatment must admit of wide 
modification, as Impotence may be absolute or 
relative, constitutional or local, direct or indi- 
rect, transient or apparently permanent. Many 
defects of conformation are sufficient, more or 
less completely, to interfere with the sexual act; 
among men, preternatural length, closure, or 
adhesion of the foreskin, constituting pliymosis 
(which may be either congenital or the result of 
disease.) Cancerous or scirrhous enlargement 
of the prostrate is frequent in advanced life, and 
forms another obvious physical bar to copulation 
Among females, adhesion of the sides of the va- 
gina is not so common as an imperforate state 
of the hymen, which occassionally closes so com- 
pletely the entrance to the internal organs, that 
the menstrual secretion has been known to ac_ 
cumulate behind that membrane, and for want 
of the natural outlet, the cavity of the womb 
has naturally assumed a distention closely simu- 
lating that of pregnancy. Some, from constitu- 
tional frigidity, are impotent ; thus we read 
that Zenobia, Queen of Palmyra, only admitted 



NERVOUS EXHAUSTION. 65 

her husband's embraces once a month, and then 
solely in relation to posterity ; it is doubtful 
whether under such circumstances her sense of 
duty would atone for the absence of inclination. 
Excessive venery, and the profuse discharges of 
flu or alius, or the whites, are susceptible of 
completely destroying all power of excitement 
in women; hence prostitutes, from over-stimu- 
lation of the generative organs, seldom conceive. 
Transient impotence is often the result of mere 
apprehension. Too eager desires, too ardent 
imagination, the ecstatic effect produced by the 
sight of a beloved object, extreme nervous sus- 
ceptibility, are often sufficient to produce tem- 
porary impotence. 

It ig not unusual to meet with instances of 
married people becoming quite indifferent to 
each other's embraces. A patient of mine con- 
fessed to me his inability to complete the sexual 
act with his wife, unless, by an effort of the 
fancy, imagination conjured up the form of 
some more voluptuous female. Physical defect 
may constitute the cause of impotence, but more 
frequently there is neither organic defect nor 
local disease ; the affection is a mere nervous 
suspension of power, which is soon removed 
under proper management. Even this has its 



66 NERVOUS EXHAUSTION. 

wise ordination. Any individual, however ner- 
vous in his physical capacity, if he anticipate 
with too intense eagerness intercourse with a 
beloved object, will seldom perform the act 
well. Even among the most ardent and pow- 
erful, it occurs, as many have confessed, that 
after waiting time after time for opportunity, 
when that has arrived, they have not had the 
power to take advantage of it ; a nervous anx- 
iety, a tremulous delight absolutely indefinable, 
has completely thrown prostrate all power, and 
the object of passion has been saved from per- 
dition by its paralyzing all the fire and ardency 
of animal desire. If the imagination wander 
from the task, temporary Impotence is the re- 
sult ; and many writers are firmly of opinion 
that impregnation is often impeded from the 
presence of ideas which interfere with the due 
performance of the generative act. Sterne has 
happily commented on this point in one of his 
most popular works, introducing his maternal 
parent as asking at a most untimely moment, 
whether his " father had not forgotten to wind 
up the clock." His views are strictly physio- 
logical. Such is the power of the moral over 
the physical state of man ! 



NERVOUS EXHAUSTION. 67 

Impotence in the male may arise, then, from 
a wide diversity of conditions. Incapacity of 
erection, generally referable to self -pollution ; 
Impotence, arising from a want of power of re- 
tention in the seminal vessels, induced by a 
morbid susceptibility of those vessels, and 
brought about in like manner by a persistence 
in the same vicious practice ; Impotence, from 
inability of retention resulting from repletion 
of these vessels, all demand a variety of treat- 
ment peculiar to the precise condition of the 
parts. Impotence from mental influence has 
also its appropriate management. Exclusive of 
this, the generative infirmity under considera- 
tion, though occasionally arising from simple - 
disease, is ascribable in by far the greater ma- 
jority of instances to the excesses of Sensualism, 
either with women, or, more commonly still, 
from that vile excess to which such frequent al- 
lusion has been made in these pages. Long- 
protracted chastity or continence is not to be 
overlooked as a cause of Impotence : the very 
reverse of the degrading habit of self -pollution, 
it is not only comparatively rare, but offers in 
its very nature the indications of cure. But 
that long-continued debauchery, whether with 
women or by masturbation, is to be assigned as 



68 NERVOUS EXHAUSTION. 

the most common and prominent of the causes 
of Impotence, is a fact admitted by all syste- 
matic writers, and amply and painfully con- 
firmed by my own experience. Mons. Pinel 
observes, — " The Impotence caused by the latter 
excess reduces youth to the nullity of old age, and 
is too often incurable" Fortunately, the re- 
cords of a numerous list of cases prove that re- 
covery of the powers of manhood is not (under 
judicious management) so altogether hopeless, 
as might seem to be the fact, trusting only to 
the observation of those medical men who have 
made these subjects their peculiar and exclusive 
studies. 

Impotence is often caused by debility of the 
genital organs, induced by precocious venereal 
enjoyments, or by the unrestrained abuse of the 
delicate structures in any method that tends to 
produce repeated and severe evacuations of the 
seminal fluid. If impotence result from self- 
pollution, there is a want of erection, and should 
a seminal emission take place, the semen does 
not possess its prolific power, and thus the man 
is at once Impotent and Sterile. This form 
of impotence is truly deplorable, and unfor- 
tunately it is the most prevalent variety ; never- 
theless, the author has cured many persons la- 



XERV0US EXHAUSTION. 69 

boring under this distressing complication, al- 
though several involuntary diurnal as well as 
nocturnal emissions have regularly occurred 
without amorous impulse. Xext to Self-pollu- 
tion, excessive yexery is a frequent cause of 
impotence, as well as of sterility among the 
male sex. This is a frequent cause of want of 
offspring in young married persons. In these 
cases, the semen may escape without the aid of 
the ejaculatory muscles, is imperfect in quality, 
devoid of power until the health be improved; 
or, if impregnation ensues, the child undoubt- 
edly partakes of the debility of the parent, soon 
to be consigned to a premature grave, the vic- 
tim of that nameless atrophy or wasting decay 
which hurries thousands of infants annually to 
the tomb. In these cases the male parent gene- 
rally suffers from inflammation of the seminal 
vesicles, or there is a seminal weakness, with 
more or less involuntary discharge. 

The surest means by which sound and vigor- 
ous children may be engendered in a good con- 
stitution, unenfeebled by excessive waste of 
those powers which in their assemblage consti- 
tute the manifestation of the living principle. 
It is admitted, not merely by philosophic writers 
who have speculated deeply upon the subject. 



70 NERVOUS EXHAUSTION. 

but by all who have paid the least attention to 
the facts connected with such a statement, that 
not merely the physical but the moral dispo- 
sitions of the parents are transmitted by gene- 
ration ; hence, if a sound mind in a sound body 
be the first, greatest, and most lasting blessing, 
and its deprivation or absence the greatest pos- 
sible, curse, how imperatively necessary is the 
obligation to calculate closely the tendency of 
vicious indulgences, to avoid the contamination 
of depraved habits, and to correct and elude 
the consequences of that debility Already im- 
posed upon the generative organs by sensual 
excess ! Impotence and Sterility are usually 
the results of wilful imprudence. Malformation 
is a direct interposition of creative wisdom ; its 
occurrence is comparatively rare ; l?ut faili?ig 
power is not only exceedingly common, but gene- 
rally constitutes a self-i7iflicted evil. Diseased 
and delicate parents procreate diseased and 
weakly offspring. The same results are observed 
in plants and animals. Can it be supposed that 
the physical powers, the sympathies of a beau- 
tiful woman of an excellent constitution are in 
unison with those of a man whose best ener- 
gies were long ago expended in the premature 
and illicit excesses of lawless excitement, whose 



KERYOUS EXHAtTSTIOX. 71 

youth has been a hurried history of wild enjoy- 
ment, whose passions haYe been lashed past the 
natural powers of his bodily organization, and 
who now brings his decrepid efforts as a worth- 
less offering at the shrine of matrimonial sanc- 
tity ? Or worse still — is there a mockery more 
deep, more bitter, than that desolation of spirit 
which an affectionate woman must feel on find- 
ing she clasps, entwined within her circling em- 
brace, the mere wreck of Sensualism, the hor- 
rible victim of self -pollution ; the creature who, 
having trained his imagination and bodily 
powers to mere fancied enjoyments, is now de- 
prived almost, if not entirely, of the capability 
of resuming the actions for which his genera- 
tive organs were destined ? Woman's scorn 
must be the more intense, because from the very 
nature of her own position she is precluded 
from giving vent to her feelings of anger and 
vexation. Love cannot be reciprocal in such 
cases ; animal or organic impulse will prefer 
that which is more accordant with itself ; even 
beasts prefer males which are possessed of vigor, 
power, and beauty, and this instinct is implant- 
ed by Nature in all animals. Whatever per- 
version civilization may effect in our feelings or 
manners, it cannot extinguish this instinct. 



72 NERVOUS EXHAUSTION". 

And this is an eminently wise ordination, as 
tending to the perpetuity of a healthy race of 
human beings. 

If Sensualism have impaired the powers, not 
of both parents, but of one only, the punish- 
ment of the offence is either Sterility or de- 
bility; or pain, disease, and death transmitted 
to the children, and reflected back with sorrow 
upon the parents. Impotence, then, is the last 
crowning scourge of sexual imperfection, and 
demands for its removal the most cautious appli- 
cation of the resources of the healing art. The 
treatment of the chronic diseases of the gene- 
rative system, has been strangely neglected and 
signally misunderstood. The efficacy of well- 
directed efforts has been much mistrusted in 
this matter, and it is remarkable that both the 
patient and practioner contribute to these im- 
pediments : for as the latter has been accus- 
tomed to see his remedies speedy in their effects, 
he is himself discouraged if they do not imme- 
diately produce the desired benefit. Nor is it 
any wonder that the patient becomes incredu- 
lous of the promised relief, neither of them 
recollecting that the morbid states have been 
slowly produced, and cannot therefore be 
speedily changed. 



KEBVOUS EXHAUSTION. 73 

Self-pollution, the frequent cause of sexual 
Impotence and Sterility, is generally the habit 
of the best years of youthful life ; and its dead- 
ening impress often tells with deplorable cer- 
tainty, Jong after the "baneful habit has leen re- 
linquished. Time must therefore be afforded 
for the rectification of that artificial state into 
which the powers of the system has been wan- 
tonly plunged. It is evidently the absence of 
fixed principles, in our pathology of the slow 
diseases of the generative system, that has 
given such unbridled license to quackery. There 
has always existed a vagueness of opinion re- 
specting their nature, and an unsettled doctrine 
as to the most rational methods to be adopted 
for their mitigation and cure. The communi- 
cation of disordered action is an inevitable re- 
sult of indulgence in any mode of Sensualism, 
either excessive, or contrary to the order of na- 
ture and the constitution of our being: and the 
nature of that perverted action may be readily 
anticipated. In fact, we see it exemplified in 
excessive irritability of the bladder and seminal 
vesicles, producing incapability for retention, 
disease of the spinal marrow and brain, spasm 
of the urethra, and stricture, an effeminate 
flaccidity of the penis, testicles, and scrotum. 



74 NERVOUS EXHAUSTION. 

Can it be expected that these organs should be 
capable under such circumstances of fulfilling 
their appropriate office in the task of procrea- 
tion ? Most assuredly not. Where impotence is 
consequent upon that baneful propensity, ichich 
cannot be sufficiently stigmatized, its extent of 
severity is far greater than ivhen produced by 
excessive indulgence with women, because the 
vital fluid that could haye improved the stamina 
of the system has been lost without satisfaction; 
consequently no gratification of the mind has 
been had in counterpoise to compensate, and in 
some measure to repair the expenditure of power. 
The man who, from his anxiety to indulge to 
the utmost his libidinous propensities, seeks for 
variety among women, may certainly find in 
such variety a new stimulus sufficient for the 
occasion, and may be able to accomplish more 
frequent repetitions of the sexual act than the 
sober married man who is faithful to one ; but 
we cannot overlook the fact that this is un- 
doubtedly accomplished at the expense of a cor- 
responding amount of unnatural excited energy, 
and the ultimate results of such efforts tell with 
fearful and tremendous horrors upon the help- 
less and debilitated votary of greedy pleasure. 
The nightly partner of a husband's bed silently 



KERV0US EXHAUSTION. 75 

offers only that gratification which is demanded 
by the sexual organs, when fully charged with 
the seminal fluid and impatient for relief ; to 
such a man, the stimulus of variety is unsought, 
contemned, forbidden, as contrary not merely 
to all laws, human and divine, but as directly 
opposed to his well-being, to the maintenance 
of his animal organization in health, strength, 
and usefulness. Here, then, the natural laws 
of his physical constitution harmonize most ad- 
mirably with the higher sanctions of morality. 
The actual amount of enjoyment realized by the 
temperate is, in the long run, far greater; power 
is maintained until old age, and a vigorous off- 
spring is engendered ; while the hasty, violent, 
and forced gratifications of the Sensualist, 
though vivid for a moment, are succeeded by 
that worst form of helplessness — insatiable de- 
sire, appended to diseased and jjowe? 'less organs. 
The draining of the seminal fluid which occurs 
either from excessive indulgence in venereal 
gratifications, or from solitary vice, is not equally 
great in every instanoe. There are some indi- 
viduals who are not rendered absolutely, but 
only partially Impotent. They can accomplish 
the sexual acts occasionally, and with severe 
effort, to the disgust, doubtless, of the female, 



76 NERVOUS EXHAUSTION. 

or they are tolerably able, yet unprolific. Their 
powers are weakened, not altogether destroyed. 
These patients have resources left in surgical 
skill, which, if expended in contending against 
improper or unskilful treatment, are lost 

FOREVER. 

The debility produced by masturbation starts 
a difficulty in the choice of remedies which does 
not occur in other cases ; to excite, yet not irri- 
tate, this is the point of divergency, where cau- 
tious science leaves Plundering quackery to pur- 
sue her blind injurious course. It is a law of 
animal organization, that when motion is in- 
creased, the increase is most considerable in 
those parts which are most susceptible, and 
these, among Sensualists, are the parts of gene- 
ration ; therefore, the effects of irritating reme- 
dies are most sensibly and instantly felt in these 
parts, enforcing the utmost circumspection not 
merely in the selection, but in the administra- 
tion and employment of medical agents. Thus, 
Sterility may be in some cases only apparent. 
Although it is perfectly true that, in a few in- 
stances, the uterine system of the female may 
be insensible to the seminal stimulus of a par- 
ticular individual, yet capable of being acted 
upon by another, the lapse of a little time is 



KERVOUS EXHAUSTION. 7? 

often sufficient (if there have been no debilita- 
ting causes in operation before marriage) to dis- 
sipate groundless fear ; and such being the 
truth, it becomes doubly important, not only 
that proper treatment be adopted where abso- 
lutely demanded, but that science should de- 
termine whether any or what kind of interfe- 
rence be really necessary. Offspring is frequent- 
ly denied to newly-married persons from eager- 
ness in its pursuit. The consequences of ex- 
cessive venery in these, whom warm passion has 
united in its indissoluble tie, amount only to 
the defeat of their wishes. Celsus remarked 
upon this subject more than eighteen centuries 
ago: "Earns concubitus corpus exbitat, fre- 
quens solvit;' 9 which may be freely translated, 
" The bodily powers are excited by occasional 
coition, by frequent repetition they become re- 
laxed," and consequently unprolific ; or as a 
poet has expressed the same sentiment — 

" While temperate pleasure spurs the lazy blood. 
Excess unstrings the nerves, and dries the flood." 

and so truly is it within the experience of many, 
that when the first warm anxiety for offspring, 
and its corresponding efforts, have passed away 
and subsided, the blessing is granted to less 
passionate, exciting, and frequent embraces. 



?8 NERVOUS EXHAUSTION. 

The ancient physicians were right in their 
general rule : the longer parties abstain, the 
more quickly they generate. Almost all phy- 
siologists now agree that the retention of semen 
for some few days, or temporary abstinence from 
coition, is necessary to generation. During my 
practice, many persons have consulted me on ac- 
count of want of family, which entirely arose 
from this cause. Such cases require great deli- 
cacy in their investigation, but it is not difficult 
to learn their nature when science, caution and 
sympathy are duly exerted. Conj ugal, domestic 
and social inconveniences must always be avoid- 
ed ; and it is scarcely to be observed, because 
of its obvious truth, that excessive sexual enjoy- 
ment relaxes both parties, and may, even in the 
married state, defeat its own and, be unfruitful, 
from too frequent repetition ; and bring on that 
atony, weakness, and debility of the generative 
organs, which may end in sterility in the female 
and impotence in the male. 

If these things be so (and who will dare to 
contravene their truth, founded as it is on the 
ordinary every-day observation of mankind ?) 
it follows that there are, and may be, varieties 
of seminal weakness, originating most com- 
monly in nocturnal emissions, and these, de- 



NERVOUS EXHAUSTION. 79 

pendent in many instances (but not invariably 
so) on the unnatural practice of self-pollu- 
tion; to which such ample reference has been 
made in the foregoing pages. That these em is- 
sums lead to the most deplorable consequences, 
independently of the injury done to the genera- 
tive function, is indisputable. The most studi- 
ous people, and those of splenetic cast, are sub- 
ject to this infirmity, and the discharge of semen 
is commonly so considerable, that they fall into 
a slow wasting consumption. A Roman phy- 
sician (whose opinion is supported by John of 
Acarius, author of a work composed for the 
Emperor) observes, "If nocturnal emissions 
continue any time, the necessary consequences 
are consumption and death; for the most bal- 
samic part of the human and animal spirit is 
dissipated ; the whole body falls away, and par- 
ticularly the back ; the patients become feeble, 
dry, and pale ; they languish in slow melan- 
choly agony." Let this antiquated, yet terrifi- 
cally correct portraiture, deter the thoughtless 
from practices which lead to such a state ; and 
those in whom it is commencing, let not in- 
cipient evil be deemed unworthy of their most 
serious consideration. 



LECTUEE V. 

THE MOKAL AND PHYSICAL EFFECTS OF SELF- 
ABUSE — SPERMATORRHEA — IMPOTENCE. 

All the faculties are weakened by indulgence 
in this yice. The sense of hearing loses its 
acuteness, and much annoyance is caused by 
noises and singing in the ears ; sometimes even 
deafness results. The eyes lose their brilliancy, 
end appear dull ; the pupils are always more or 
less dilated. According to Eichter — one of the 
most eminent of surgical authorities — " No 
general tvealcening causes operate upon the eyes and 
occasion total blindness so powerfully and so often 
as premature and excessive indulgences in venereal 
pleasures. 77 Another of the evils resulting from 
self -pollution is a failure in the power of the 
mind, especially the memory. In short, it may 
be stated with the utmost confidence that there 
is not an intellectual faculty with which the 
beneficent Creator has blessed us that is not 
liable to be impaired by these causes. It is a 
curious fact that the habit of self-pollution is 
invariably followed by a diminution in the size of 
the penis. The organ shrinks to one-half its 
former outline, or, in those who have practised 



XERTOUS EXHAUSTION. 81 

it in youth, does not attain to full growth. The 
power of perfect erection is altogether destin- 
ed ; when coition is attempted, the requisite 
solidity is not maintained, or if an entrance in- 
to the vagina be partially effected, it is followed 
by a premature emission. Let not the victim, 
of secret vice natter himself his unmanly act 
escapes detection. Dr. Armstrong observes — > 
" I think I should know a person in the streets 
who has addicted himself to this vice, by merely 
walking behind him, from his peculiar gait." 

From the commencement of the unfortunate 
habit of self -pollution, which is invariably the 
cause of seminal weakness, there is frequently 
a loss of desire for sexual intercourse ; or where 
the desire is felt, a repetition of the unmanly 
habit is preferred to coition in a natural way. 
This, when persisted in, causes the face to be- 
come pale, bloated, and cadaverous, the body 
feeble and emaciated, and an impeded circula- 
tion in the extremities. Then occur trembling 
hands, dim eyes, confused ringing in the ear, 
sometimes deafness, accompanied with frequent 
and violent headache. A nervous dread and 
loss of energy are very common, and we have 
frequently heard patients confess that they have 
walked their rooms for hours together at night, 



82 i^EKVOUS EXHAUSTIOK. 

fearing to go to bed. This is often experienced 
when the nocturnal seminal emissions are nu- 
merous. We may here observe that the prac- 
tice of Onanism may sometimes be indulged in 
without apparent ill effects for a time. Some 
are affected in a month or two, some may escape 
for years ; but not any entirely escape, for it is 
impossible to violate any law of Nature and of 
Nature's God without evil consequences result- 
ing. The practice of Onanism is a moral and 
physical crime, consequently the punishment is 
twofold. Thus, while the bodily vigor is lost, 
and the senses lose their keenness, the mind 
also becomes affected, the memory fails, the 
judgment becomes defective, and the patient 
becomes unable to any exertion, bodily or men- 
tal. Such is the history of many cases of sui- 
cide of which we read in the newspapers ; cases 
mysterious, at first sight causeless, but under- 
stood by the educated physician, regarding them 
by the clear light of science. Tissot, the cele- 
brated physician and early writer on this sub- 
ject, states the result of this practice to be, 
First : — Total derangement of the stomach, 
shown in loss or irregularity of appetite and 
indigestion. In some cases the appetite be- 
comes almost voracious : Nature thus endeav- 



tf ERVOtTS EXttAtJSTlOK. 83 

ouring to repair the loss inflicted upon her. 
Second : — Weakness of the respiratory organs ; 
whence frequently result dry coughs, almost al- 
most always colds, weakness of the voice, and 
sense of suffocation on slight exertion. Third : 
— General relaxation of the nervous system, 
lassitude by day, painful dreams by night ; the 
sleep is unrefreshing. Fourth : — Great debility 
of the organs of generation ; almost all com- 
plaining of only imperfect erections ; desire no 
longer exists, and impotence results. Noctur- 
nal emissions are a terrible scourge to these suf- 
ferers, and often overwhelm those even whose 
organs are absolutely senseless when awake. 
When these patients have had nocturnal pollu- 
tions, they find themselves the next day in a 
state of depression, of discouragement, debility, 
ennui, and lassitude, with pains in the loins, 
head, and eyes. Fifth : — Eruptions frequently 
appear on the face and forehead ; the features 
become changed from the rosy hue of health to 
a dull, heavy, and sallow complexion. 

We will conclude this part of the subject with 
a few words respecting spermatorrhoea and im- 
potence. This term spermatorrhoea is derived 
from two Greek w^ords, signifying a flowing of 
seed, and is applied to all cases in whioh an 



84 XERV0US EXHAUSTION. 

emission of the seed takes place, excepting from 
coition ; in other words, spermatorrhoea maybe 
termed an involuntary loss of the semen. The 
usual causes of this disease are self-pollution, 
but it may also be the result of immoderate in- 
dulgence in coition, of ill-cured gleet, and fre- 
quently of disease of the prostrate gland. Con- 
stipation of the bowels, and the irritation of 
the rectum caused by piles, may also predispose. 
But after all, the influence of these causes is 
insignificant compared with that of self-abuse. 
The symptoms of spermatorrhoea may be divided 
into local and constitutional. The local symp- 
toms are generally emissions of seed at night ; 
and we call the particular attention of our 
readers to this rule. Nocturnal emissions are 
decided signs of debility and symptoms of ap- 
proaching impotence. Let it be remembered 
that every drop that escapes is the habitation of 
living beings, a particle of the living seed, and 
that one drop, under favorable circumstances, 
is sufficient to give life to a future being. With 
respect to diurnal emissions — which occur at 
stool, whilst making water, or which are evident 
in a continual moisture and humidity of the 
organs — they are of a complicated character, 
and in many instances are undiscovered and 



KERVOTJS EXHAUSTION. 85 

unsuspected by the patient until the disorder 
has assumed a most formidable character; for 
he is quite unconscious of any seminal loss. 
The nocturnal emissions sometimes leave him 
entirely, the drain by day being so excessive ; 
but at last some formidable symptoms force him 
to seek relief at the eleventh hour. During 
the progress of spermatorrhoea many patients 
suffer from a hard dry cough, a difficulty of 
breathing, pains in the chest, and hence are 
treated for consumption ; for the constitutional 
symptoms of spermatorrhoea are innumerable, 
and when the cause of disease is unknown and 
unsuspected, the general practitioner will natu- 
rally attack the symptoms. The appetite, at 
first, will frequently increase and become vora- 
cious — it is the effort nature makes to support 
the failing strength. All the senses are more 
or less affected — the eye loses its brilliancy, 
there is always more or less dilatation of the 
pupil, and the very look of the patient reveals 
his secret to the glance of experience. The 
penis and testicles become small and relaxed ; 
and a high surgical authority observes, the in- 
firmity may not inaptly be termed a consump- 
tion of these glands. And we cannot be as- 
tonished at the frightful effects caused by un- 



86 k Eftvous EXtfATisttOtf. 

natural emissions of seed, when we recollect 
that physicians of all ages are agreed that the 
loss of one ounce of semen by self-abuse, noc- 
turnal emissions, or at stool, injures the system 
and weakens it more than the abstraction of 
twelve ounces of blood. In the early stages of 
seminal weakness, different persons are various- 
ly affected ; some are incapable of procuring a 
discharge of semen into the cavity of the female 
genitals in a natural way, though they may 
effect temporary erection ; while others cannot 
perform the act of copulation, from the emission 
taking place too quickly, and before the proper 
firmness of the male organ has enabled it to 
effect the requisite penetration. To recapitu- 
late briefly the results of our experience : — Im- 
potence, the effect of long-continued sperma- 
torrhoea, is the inability to perform the venereal 
act. Those cases are most difficult to cure 
w r hich have been caused by self -pollution ; but 
science, combined with skill and experience, 
will almost effect miracles, and our treatment 
of these cases has been moct successful. Impo- 
tence is also caused by too free indulgence in 
sexual pleasures ; these cases can be cured with 
comparative ease by rest and tonic medicines. 
Impotence is sometimes the result of moral 



NERVOUS EXHAUSTION. 87 

causes — nervousness, too much respect, &c; 
the treatment is obvious. Impotence, then, is 
chiefly caused by debility of the genital organs; 
there is a want of erection, and if a seminal 
emission takes place, the semen does not possess 
its prolific power, and the man is at once impo- 
tent and sterile. Sterility, or barrenness, is 
sometimes the vice of female organization, and 
is produced by various causes ; amongst others 
which entail a loss of vital and productive 
energy, excessive indulgence is one of the most 
prominent. Excessive venery is a frequent 
cause of want of offspring in young married 
people. In these cases the seed does not ac- 
quire sufficient vitality to stimulate the ovum 
in the womb ; and even if a child should come 
to life, it partakes of the debility of the parent, 
and is soon hurried to a premature grave, the 
victim of that nameless atrophy or wasting 
away which kills its thousands of infants annu- 
ally. Impotence and sterility are usually the 
result of wilful imprudence. Malformation is 
very rare ; but failing power is not only exceed- 
ingly common, but generally constitutes a self- 
inflicted evil. The author is frequently con- 
sulted by those contemplating marriage, and 
whenever bad habits have existed, or weakness 



88 NEEVOUS EXHAUSTION. 

is experienced, the precaution is most wise, and 
may prevent much future unhappiness. Like- 
wise, as respects the married man, it often oc- 
curs that a few minutes' confidential conversa- 
tion with one who has made these subjects a 
special study is attended by the happiest re- 
sults. There are resources in the science of 
medicine, and few, very few, need despair of 
restoration to the power of manhood. But we 
will refrain from further details ; our object is 
friendly suggestion, not importunate dictation. 
We will conclude this chapter with a few words 
of the celebrated Lallemand: — "Many diseases, 
when left to themselves, work their own cure, 
providing only they be not exasperated by the 
imprudence of the patient. This is not the 
case with spermatorrhoea, chiefly, perhaps, be- 
cause the effects produced by the disease itself 
are favorable to the increase of involuntary dis- 
charges. The natural tendency of this disease 
to become aggravated, as the result of its own 
effects, frequently leads to a fatal termination. 
The patients generally expire in one of the at- 
tacks of syncope that follow congestion of the 
brain. In this way such of the insane who have 
fallen into a state of dementia usually expire. 
Many die from diseases (as consumption, &c.) 



KEHVOUS EXHAUSTION. 89 

aggravated and inflamed by unsuspected sper- 
matorrhoea ; the symptoms are treated by the 
physician, but the great cause, spermatorrhceal 
remains unsuspected." 

MODERN TREATMENT OF SPERMATORRHEA, SE- 
MINAL WEAKNESS AND NERYOUS DEBILITY. 

Like many other intractable diseases, sperma- 
torrhoea has been the "opprobrium? medicorum" 
of the regular practitioner. From its tedious- 
ness, the medical man is wearied of it ; and like 
an obstinate gleet, after trying all possible 
remedies, has given it up in despair. Nor is 
this altogether to be wondered at, when we 
consider the extreme difficulty of the diagnosis, 
excepting by microscopic observations ; and to 
use the microscope in these cases with effect re- 
quires skill, care, experience, and a thorough 
knowledge of the disease. Spermatorrhoea is a 
drainage, a waste, a dribbling away of the semi- 
nal fluid. As already explained, it may exist 
unknown, and, consequently, unattended to 
until great mischief has been inflicted on the 
constitution and vital powers. Now, what are 
the indications of treatment ? Naturally, to 
give tone to the vessels that neglect their office; 
to prevent the too profuse secretion of tha 



90 HERVOTJS EXHAUSTION. 

impoverished fluid ; to esablish a healthy reli- 
ance between the two ; to remove the provoking 
causes that brought about the first estrange- 
ment ; to repair the mischief done to the gene- 
ral health ; to cultivate the mind into a higher 
notion of its importance, and thereby withhold 
the irritating consequences of disordered im- 
agination. The treatment, then, of spermator- 
rhoea and its accompanying affections, mental 
and physical, may be divided into — First: — 
Local and Constitutional; Second: — Moral and 
Dietetic. The first step on which we must in- 
sist is the relinquishing of those practices which 
have occasioned the disease. This is essential ; 
the most careful and the most scientific treat- 
ment must otherwise increase the mischief, 
and, by giving greater temporary strength, en- 
able the patient to inflict on himself more per- 
manent evils. A due attention to air, exercise, 
sleep, and regimen is in all eases proper, and 
entirely within the control of the patient. A 
local remedy of great value is cold water ; the 
sponge-bath or shower-bath should be used in 
the morning, a small quantity of bay salt being 
dissolved in the water. Coarse towelling and 
flesh-brushes should be used after the bath ; a 
suspensory bandage should be used ; the diet 



NERVOUS EXHAUSTION. 91 

should be generous, but not stimulating, animal 
food in moderation, and he should eat a little 
and often, rather than take too full a meal. 
Exercise must not be neglected, moderate at 
first, and gradually augmented. Stimulating 
drinks are improper, spirits in all cases hurtful; 
a glass or two of wine may be taken if demand- 
ed by previous habit. In this case a pale dry 
sherry will be best. With respect to medicines, 
a sketch only of the treatment can be offered. 
Cases vary so widely, that the curative means 
must be varied accordingly. The class of drugs 
which allay excitement and irritability are first 
likely to be required, for the stomach is so 
weakened and capracious that the disease is 
frequently mistaken for indigestion. Mild and 
cordial laxatives, alterative drugs, with neutral 
salts, febrifuges, and sedatives, will soon quiet 
the system, and enable it to tolerate tonic or 
restorative medicines ,which if commenced with 
are decidedly injurious. But what is the mean- 
ing of tonic ? for no word is so much misap- 
plied. One man means quinine, another iron, 
a third the mineral acids, whilst a fourth means 
stimulants, and so on through the whole Phar- 
macopoeia. Now, we mean, not any one, but 
the whole class of medicines combined, changed. 



92 NERVOUS EXHAUSTION. 

increased, or diminished to suit the particular 
case ; in this consists the real art of scientific 
prescribing. One man gradually gathers 
strength from quinine, which would not suit 
another, whose deteriorated blood-globules will 
become red and healthy under the exhibition of 
iron, in some of its numerous preparations. 
The peculiarity of our treatment consists not 
only in the selection of hitherto undiscovered 
remedies, but in the practical adaptation of 
those we already possess. And the above are 
but a few of the remedies we employ in gene- 
rative diseases or debility. Amongst the most 
certain and most valuable for the total cure of 
spermatorrhoea — which control that disease 
completely, even when caused by long continued 
habits of self-abuse — are medicines whose very 
names are unknown to the general practitioner. 
Under the tropical sun of India, in Thibet, 
and the mountainous ranges of North-eastern 
Hindustan, in the forests of Ceylon, are found 
plants and herbs grown from the virgin soil, 
rich in balsamic virtues, aromatic and cordial. 
India, the land of ancient civilization, the 
original home of medicine, still retains secrets 
which baffle the wisdom of learned physicians. 
Who has not read and wondered at the marvel- 



NERVOUS EXHAUSTION. 93 

lous stories of the power and influence exerted 
by the " Old Man of the Mountains ?" The 
means by which he exerted his influence, by 
which he retained the power of life and death 
over his followers, by which he compelled them 
to the most desperate enterprises, were com- 
prised simply in his knowledge of the herbs, 
flowers, and grasses under his feet. Have these 
wondrous gifts of Nature now lost their virtue? 
I boldly answer, No ! I am in possession of 
remedies marvellous in their influence, most 
effective in their result, by which I control the 
worst cases of disease and debility, and which 
account in a measure for the extraordinary suc- 
cess I have . met with in special practice. So 
when Debility has weakened the mental facul- 
ties ; when a long course of dissipation and 
solitary habits has destroyed enterprise, energy, 
and courage ; when a man feels that he is a 
wreck in body and in mind, and dares not even 
own it to himself — surely in such cases these 
remedies are called for. And no man can treat 
successfully the diseases described in these 
pages whose medicines are limited to those con- 
tained in the American Pharmacopoeia. It is 
a question often asked — Is sexual intercourse 
indispensable to health ? The reply may be 



94 NERVOUS EXHAUSTION. 

taken that at least Nature destined the act of 
generation for procreative purposes, and that 
not only should it contribute to the delight of 
mankind, but also to their health. Hence 
copulation is permissible and necessary, ex- 
treme chastity frequently injurious ; and we 
often find it advisable to recommend marriage. 
It should also be remembered that copulation 
should never be an effort. This is a golden 
rule, and where great languor, drowsiness, de- 
pression, and a feeling of physical exhaustion 
follow the act, the time chosen has been inapt, 
or the limits have been exceeded. We will con- 
clude this part of the subject with a few words 
respecting treatment. Having enjoyed for 
many years the friendship of the late celebrated 
Lallemand during our residence in Paris, our 
practice in cases of spermatorrhoea has neces- 
sarily been most extensive. The peculiarity of 
our treatment is to act directly on the seminal 
vessels, to strengthen without exciting, and so 
restore health by removing the cause of disease. 
It would be easy to recommend various reme- 
dies ; but medicine in the hands of the timid, 
the irresolute, or the ignorant, is more likely 
to produce evil than advantage. In all cases 
let the best advice be sought from one who has 



NERVOUS EXHAUSTION. 95 

made these diseases a special study. Some may 
be prevented from applying for assistance from 
dread of accidental exposure ; it may, there- 
fore, be proper to remark, that it is our rule to 
destroy all correspondence at the termination 
of each case ; or, if preferred, to return it to 
the writers. Inviolable secrecy and certain re- 
lief are the boons we offer to suffering humanity. 
Unfortunately, practitioners in this country 
have long been averse to selecting this branch 
of medical art as a study ; many distinguished 
men have risen to fame and affluence by devo- 
ting their talents to midwifery, operative sur- 
gery of the eye and ear, &c. The author of 
this treatise is content to brave the sneers of the 
ignorant and envy of the malicious, when he 
reflects on the gratitude of those whom he has 
rescued from an untimely grave ; he knows that 
in selecting this peculiar department of medi- 
cine his usefulness has been increased, and that 
he deserves well of his fellow-men. 

OX CERTAIN URETHRAL DISCHARGES. 

We shall not here consider the gonorrhoeal 
discharge, as that is treated on in another part 
of the work. There are, however, other dis- 
charges, and of a serious nature, which often 



96 HEftVOUS EXHAUSTION. 

call for skilful' and attentive treatment. The 
first of these is termed gleet, which is the con- 
sequence of an ill-cured or neglected gonorrhoea 
or clap. There is another discharge, a dis- 
charge of semen, without sensation, which is 
the result of a debilitated frame, and is fre- 
quently induced by long-continued self -pollu- 
tion, or long residence in hot or cold climates. 
The penis is invariably damp and clammy ; 
there is a slight mucous discharge rather thicker 
than ordinary clap, which sticks in patches on 
the linen, and between the nut and foreskin of 
the penis. Under the microscope this dis- 
charge is found to consist of spermatozoa, fre- 
quently in a mutilated state, and free from 
vitality. The affection is characterized by the 
emission of semen upon the very first attempt 
at sexual intercourse, and often before a regular 
erection can take place; sitting in a warm room, 
horse exercise, and many trivial causes will 
produce it. The emission causes little or no 
sensation, excepting sometimes a slight spasm. 
These discharges are not contagious, but sexual 
intercourse should be studiously avoided on 
account of the great injury that may result to 
the patient. Such discharges are generally 
connected with deficiency of generative power. 



KERVOUS EXHAUSTION. 97 

In one instance under our notice, impotence 
was almost complete ; in another (a married 
professional man), the powers had greatly de- 
clined. These patients were in the prime of 
life ; both had, however, led irregular lives. 
The irritation in cases of this nature will gene- 
rally be found to exist in the prostate gland, 
which is often enlarged ; hence a frequent de- 
sire to urinate, and a feeling as if the bladder 
were never completely emptied, and as though 
a few drops of urine were retained in the pos- 
terior part of the urethra. This form of dis- 
charge is generally confounded with a common 
contagious clap, and treated vigorously with 
copaiva, cubebs, and injections. A cure by 
these means is utterly impossible ; the disease 
is increased, as the general health suffers from 
the remedies. It is, however, quite true that 
these patients have previously suffered from 
gonorrhoea, in some instances more than once. 
But in order to cure, we must purify the blood, 
and strengthen the parts. The subject, alto- 
gether, is well worthy the careful attention of 
the profession, for these cases are decidedly on 
the increase. 



LECTIIBE VI. 

VENEREAL DISEASE — HISTORY. 

Had the disease, since known by the name of 
Venereal, been a familiar one, possessing no 
features different from those already recognized 
as characterizing affections of the genital or- 
gans, and yielding to an already ascertained 
treatment, we naturally should expect that the 
authors who might notice it would never have 
thought of designing it as new and unknown ; 
neither would they have expressed terror at 
encountering it, nor expressed their entire 
ignorance as to the means of cure. Such, 
however, we find to be the fact, from universal 
testimony of the writers of the age. The ap- 
pearance, indeed, of this new form of disease 
was an event so important that mention of it 
was made, not only by physicians, but the his- 
torians living at the period also record the cir- 
cumstance. We will cite the authority of 
Gonzalo Hernandez de Oveido, and refer our 
readers to his curious volume, in black letter, 
in the library of the British Museum. The 
date is 1526, "Sumario cle la Natural Hystoria 



NERVOUS EXHAUSTION". 99 

de las Indias ;" and Oveido distinctly states the 
American origin of venereal, and the inability 
of the physicians to cure it. Another historian 
of the period, Lopez de Gomera, writes, "Be- 
cause it was a new disease no one knew what to 
do." Other contemporary writers, Paul Jovius 
Guieciardini, &c, express themselves to the 
same effect. Most of the early writers attribute 
the disease to God's anger ; some to conjunction 
of the planets ; others, of more matter-of-fact 
views, were disposed to ascribe its origin to 
another kind of conjunction, of not so celestial 
a nature ; for there are authors of this date 
who distinctly notice the primary sores or 
chancres, and trace them to their real origin — 
contagion by impure intercourse ; they mention 
strong salivation by mercury as a cure. Joseph 
Greenbank, who describes his own case, in a 
work written with much purity of Latinity for 
the age, attributes the cause to planetary in- 
fluence. He wished to keep it secret from his 
friends, but they found him out "from the 
change in his complexion ;" and no sooner was 
it known (and the fact shows in what terror the 
disease was held), than " his dearest friends 
and relations fled his presence, as they would 
an enemy with a drawn sword." The notion 



100 NERVOUS EXHAUSTION". 

prevailed that it could be caught by merely 
breathing the same air with the infected per- 
son ; hence the lower orders were driven into 
the woods and fields, and left to perish with- 
out solace or assistance. It formed one of the 
charges against Cardinal Wolsey, that " when 
laboring under venereal he had breathed upon 
the king in whispering to him.' 7 Hence, being 
looked upon as a contagious disease to which 
any one was liable, the physicians of the age did 
not scruple to publish the cases of princes — 
and even churchmen — who had the disease; and 
most of the medical works on the subject are 
dedicated either to princes or dignitaries of the 
Church. Another opinion was very prevalent 
— even now the belief is not yet extinct — that 
any one having the disease, by transmitting it 
to another relieved himself ; though it was 
asserted that, to make the experiment success- 
ful, it was necessary that the person to whom 
the infection was to be transferred should never 
before have had sexual intercourse. It is 
scarcely necessary to add that this atrocious 
and ridiculous belief gave rise to most disgrace 
ful outrages. The manner in which the new 
disaase ran its devastating course, spreading in 
distant countries with a rapidity which, joined 



KEKYOUS EXHAUSTION. 101 

to a complete ignorance of treatment, truly 
appalled mankind, must be acknowledged to 
constitute a proof of its newness — and univer- 
sal testimony leaves no doubt on that score. 
That it was first brought from the island of St. 
Domingo, then called Hispaniola, by the fol- 
lowers of Columbus, there is abundant and 
satisfactory proof. Few of the Spaniards es- 
caped who had connection with the native wo- 
man, and the ships of Columbus proceeding to 
different ports, the disease spread over Europe 
with wonderous rapidity. In 1526, Joseph 
Grunback informs us "that on returning from 
his travels, he found disease prevailing all over 
Germany — in every town, city, camp, village, 
and cottage — as well as the greater part of Eu- 
rope." In the same year we are told by Sebas- 
tian Brant that it had got to Britain ; and in 
149 7, James IV. of Scotland, in consequence 
of the frightful prevalence of venereal in Edin- 
burgh, issued the celebrated proclamation ban- 
ishing the infected from the city. The original 
is preserved in the records of the town council, 
dated September 22d, 1497, and is a very curi- 
ous document. His "Majesty charges all man- 
ner of persons being within the freedom of this 
burt, (juilks are infectit, or has been infectit. 



103 NERVOUS EXHAUSTION. 

uncurit with this said contagious plague, called 
the G-randgor, devoyd, red, and pass furt of this 
toun, and compeir upon the sandis of Leith, at 
ten hours before none/' — those evading this 
ordinance "selle be brynt on the cheik with 
the marking irne, that they may be kennit in 
tyme to cum." 

"We may also cite here the more generally 
known a Arreste " of the Parliament of Paris, 
respecting the venereal, dated March 6th, 1496, 
stating that " Because in thys City of Paris 
many persons were sick of a certain disease 
called the ' Great Pocks/ which had raged in 
this kingdom for the last two years, as well in 
Paris as in other parts of France ;" and as there 
was reason to apprehend that it would increase 
as the spring advanced, it was advised to pro- 
vide accordingly. Thus all strangers having 
the disease were to leave in twenty-four hours, 
and forbidden to enter the city until perfectly 
cured. The 2d article ordained, " That every 
citizen being diseased confined himself to his 
house." No communication was allowed be- 
tween the sick and the inhabitants, under pen- 
alty of imprisonment ; and the city gates were 
carefully watched. The general prevalence of 
the disease can only be accounted for by the 



HERVOUS EXHAUSTION. 103 

undoubted licentiousness of the age— -as we 
have no reason for believing that then, any 
more than at present, could it be propagated 
except by actual contact of the venereal matter. 
We have enlarged on this subject rather more 
than we intended, in order to prove the great 
difficulty experienced from the earliest period 
in eradicating this disease. We have studied 
the subject closely — we have reviewed the mode 
of treatment from the earliest period up to the 
present time, and we most unhesitatingly and 
emphatically declare that we have reduced the 
treatment to a certainty ; that we possess the 
means of eradicating the venereal virus from 
the constitution without the smallest inconve- 
nience to the patient, and that no case leaves 
our charge without a thorough and perfect cure 
being effected ; that we prevent the possibility 
of secondary symptoms, and the numerous skin 
diseases to which it gives rise ; and, lastly, our 
treatment applies to all who have taken mer- 
cury, or have been improperly treated by others. 

DISEASES OF I^FECTIOX — GONORRHOEA OR CLAP. 

Gonorrhoea may be defined to be a contagious 
inflammatory disease of the mucous membranq 
of the urethra or urinary canal, caused by 



104 iSTEEVOUS EXHATJSTIOK. 

impure sexual connection. It sometimes ap- 
pears the first or second day, but the usual 
average is from seven to eight days after inter- 
course. On the other hand, it is sometimes 
delayed for two, three, or even four weeks. At 
first, the patient feels an itching at the tip of 
the urethra, the lips of which appear swollen 
and of a deep red ; this is followed by a dis- 
charge of matter and great pain and scalding 
in making water. In all cases of gonorrhoea, 
advice should be obtained as early as possible ; 
early attention insures a speedy cure ; and it 
may be laid down as a general rule, that the 
longer the disease is allowed full scope, the 
more difficult and obstinate is its removal. 
Where there is much inflammation, the bowels 
should be kept open with the following aperient 
draught : — 

R. Magnes. sulphatis, unciam j. 

Infus. sennae comp., unc. vss. 

Ext. glycyrrh., scrup. ij. 

Tinct. jalapi, drachm, iij. 

Spt. amnion, aromat., drachmam j. 
Mis. Fiat mist, aperient. Cap. 1-4 partem pro 
re nata. 



NERVOUS EXHAUSTION. 105 

That is,, take of — 
Epsom salts, 1 oz. 

Compound infusion of senna, 5 ^ oz. 
Extract of liquorice, 2 scruples. 
Tincture cf jalap, 3 drachms. 
Spirit of aromatic ammonia, 1 drachm. 
Mix, and take one-fourth part as occasion re- 
quires. 

A cooling lotion may also be useful. Apply 
the following two or three times a day : — 

R. Muriat. amnion., drachmam j. 

Liq. plumbi diacet, drach. ij. 

Spt. yini rect., unciam j. 

Aq. font., una y. 
Mis. Fiat lotio. 

That is, take of — 

Muriate of ammonia, 1 drachm. 
Liquor of lead, 2 drachms. 
Rectified spirits of wine, 1 oz. 
Dilute acetic acid, 1 oz. 
Spring water, 5 oz. 
Mix for a lotion. 

[The bottle should be carefully labelled, 
" The Lotion."] 



106 NEftVOUS EXHAUSTION. 

During the progress of gonorrhoea, attention 
to cleanliness cannot be too strongly recom- 
mended. A warm bath should be taken occa- 
sionally, and the penis should be bathed as 
frequently as possible in warm water, or milk 
and water, to destroy the acrimony of the dis- 
charge, and to prevent its irritating action on 
the skin. Great comfort will be experienced 
by the patient suspending the testicles in a 
small bag so as to support them while walking, 
&c. This simple precaution frequently pre- 
vents swelled testicles, one of the most painful 
effects of gonorrhoea. The diet should be care- 
fully regulated in the early inflammatory stage; 
the food should be light, but nutritious, and 
not highly seasoned. Wines, spirits, and malt 
liquors should be avoided ; the patient may 
drink freely of thin linseed tea, or barley-water. 
The following may also be grateful: — Cream of 
tartar, one oz. ; boiling water, two quarts; strain, 
and sweeten with lump sugar, according to 
taste. We frequently cure slight cases oFgon- 
orrhoea in four-and-twenty hours ; others in 
three days ; and, with common attention on 
the part of the patient, and observance of the 
above simple rules, our average of severe 
attacks is from six to eight days. 



NERVOUS EXHAUSTION. 107 



GLEET, 



In which the discharge loses its irritable malig- 
nity, is of alarming consequence in its duration. 
It cannot be too frequently asserted that gleet 
is highly contagious, and produces a gonorrhoea 
as speedily and as certainly as the more inflam- 
matory disease. Gleet will remain chronic for 
weeks, months, or even years, and vary in in- 
tensity according to changes in diet, &c. ; so 
much so, indeed, that well-informed medical 
men have mistaken it for a fresh contagion of 
gonorrhoea, and by treating it accordingly have 
caused much misery to the luckless patient. In 
these cases microscopic observation is of essen- 
tial importance ; by its means the true cause of 
disease is at # once detected, and its extent 
clearly defined. Gleet and seminal weakness, 
gonorrhoea and seminal weakness, arising from 
self -pollution, are frequently co-existent, though 
not necessarily connected. When they do exist 
together, the disease assumes a most obstinate 
form. The value of the microscope is that it 
proves, with certainty, if spermatozoa, or the 
seminal fluid, be present in the discharge or in 
the urine. The treatment must vary accordingly. 
A new and unsuspected feature is introduced, 



108 NERVOUS EXHAUSTION. 

icMcli baffles the routine adopted by the general 
practitioner. Hence the importance of a special 
and careful study of these diseases. In cases 
of mismanagement or carelessness, and some- 
times by suddenly stopping the discharge by 
means of astringent injections, an active in- 
flammation of the testicles may occur, accom- 
panied with much pain and swelling. The fol- 
lowing case occurred in our practice a few 
months ago : — A gentleman, who had just re- 
turned from a continental tour, consulted us. 
Three years before he had contracted gonor- 
rhoea, which terminated in gleet ; he had been 
under the care of several gentlemen, the last a 
practitioner at Berlin, who prescribed an injec- 
tion, which brought on swelled testicles ; be- 
sides which he suffered from a stricture. The 
immediate pain and swelling had been relieved 
by the repeated application of leeches, but the 
smallest exposure to cold or damp brought on 
a return. The testicles felt hard, and there 
was not the slightest inclination for sexual in- 
tercourse. We caused, by our remedies, a very 
considerable discharge from the penis, which 
we encouraged as much as possible. This 
soon removed the hardness of the testicles, 



tfERYOUS EXHAUSTION. 109 

and reduced them to their natural size. The 
gentleman was perfectly cured in ten weeks. 

STRICTURE 

Is generally caused by a long-continued gleet, 
though there are cases in which it is produced 
by Onanism. The first symptoms of a stricture 
are a slight difficulty in the act of urinating, and 
a division or twisting of the stream of water. 
In all cases, however slight, apply immediately 
for medical assistance. Stricture never yields 
unassisted ~by art. Much suffering may be 
avoided by observing this rule. 

SYPHILIS, OR POX, 

Is the most dangerous and malignant of all 
forms of venereal disease. It hangs about the 
system for years, producing secondary and ter- 
tiary symptoms, intense pains in the back and 
loins, ulcerated sore throat, &c. In syphilis 
we have a virulent blood-poison, through which 
every tissue is affected. Indeed, the complica- 
ted mischief arising from this malady is known 
only to him who has an opportunity of seeing 
it in every shape and form under which it ap- 
pears. The syphilitic disease kills great num- 
bers in the prime of life, destroys the comfort 



110 tfERVOffS EXtl AtlSTIOH. 

of the matrimonial bed, and transmits morbid 
predispositions to declining years. To conceal 
their imprudence the inexperienced permit 
themselves to be surcharged with mercury, 
which, in this variable climate, is liable to in- 
duce the most fatal inflammations and pulmo- 
nary diseases, to which they ultimately fall 
victims, without creating in their families the 
slightest suspicion of the real cause of their 
death. A most important feature in the history 
of syphilitic diseases is the fact of their trans- 
mission from the parents to the offspring. Dr. 
Burns, in his work on "Midwifery," observes 
that "infection may happen when neither of 
the parents has at any time any venereal swell- 
ing or ulceration, and perhaps many years after 
a cure has been apparently effected. I do not 
intend to explain here the theory of syphilis, 
but content myself with well-established facts. " 
In these cases miscarriages frequently occur 
without evident cause ; or should the child be 
born alive, it is covered with copper-colored 
spots on various parts of the body ; the eyes 
are inflamed, and there is a mucous discharge 
from the nostrils. Should it unfortunately 
survive infancy, it will only be to fall a prey to 
scrofula or consumption at a later period. Dr. 



NERVOUS EXHAUSTION. Ill 

Hunter records a case of a couple who had been 
married twelve years, during which neither 
party was diseased, nor had been unfaithful. 
The husband had syphilis two years before 
marriage, but considered himself cured. The 
two first children were healthy ; the next two 
feeble, and soon died ; the last child was put 
out to nurse, and having a sore mouth, soon 
affected the nurse with sore nipples, and blotches 
resembling syphilitic sores. Dr. Hunter treated 
both husband and wife for secondary symptoms; 
the lady, who had been weakly for years, was 
soon restored to vigorous health ; and three 
children, who were subsequently born, remained 
perfectly well. The local sores produced by 
syphilis are term chancres : they are sometimes 
single ; sometimes two, three, or four are pre- 
sent. The chancre generally makes its appear- 
ance four or five days after the impure inter- 
course ; but, as in gonorrhoea, the time varies 
from one day to thirty. A small inflamed spot 
is first perceived, the scab drops off, and a 
larger one is formed beneath, which rapidly 
enlarges. An excavation appears in the centre, 
the skin in the neighborhood is indurated and 
thickened, the hard base being characteristic 
of syphilitic sores. After some time, and even 



112 KERYOUS EXHAUSTION. 

when the original spot is healed, the groin (one 
or both) becomes affected ; they suppurate and 
burst, forming what are called buboes. The 
throat, the nose, tne shin, the iones, are suc- 
cessively attacked, and if neglected or maltreat- 
ed, death may and does frequently ensue. 
Syphilis, perhaps, may not be regarded as a 
directly fatal disease, although its effects are so 
deplorable, especially in bad constitutions. It 
is indirectly that this disease is so very destruc- 
tive to life by poisoning and debilitating the 
frame, and thus exposing it to innumerable 
forms of disease. In questioning patients in 
hospitals and dispensaries as to their previous 
history, how often is it found that venereal 
disease is the first link of the chain which is 
dragging them to the grave ! Syphilis was 
firft recognized in Paris, in 1497 ; for along 
time no hospitals would receive patients, and 
the poorer classes of them were driven to the 
woods and fields, and left to die without com- 
fort or assistance, even by medical men. Some 
years after, the mercurial treatment was adopt- 
ed, which, with few exceptions, is used at the 
present day. Now, it may be confidentially 
asserted that as much misery has been and is 
caused by the use of mercury as by the disease 



NERVOUS EXHAUSTION. 113 

itself. Witness the rotten skulls and diseased 
bones exhibited in our anatomical collections ! 
Let us again urge all patients suffering from 
syphilis in any of its forms to apply at once to 
a qualified and experienced medical man. We 
have seen so much misery, loss of health, loss 
of ©very enjoyment which renders life a bless- 
ing, resulting from this disease, and from its 
improper treatment by mercury, that we will 
not countenance, even indirectly, any attempt 
at self-cure. 

SECONDARY SYMPTOMS, EFFECTS OF MERCURY, &C. 

Some weeks after a chancre is apparently 
healed, especially after the use of mercury in 
any of its forms, a slight redness is perceived 
oh. the scar, which becomes rather painful ; or 
a swelling appears in the groin. A general 
sobsq of, discomfort is experienced, and in a 
short time the well-marked secondary symptoms 
occia.r. When the poison attacks the throat or 
palace, the roof of the mouth becomes red and 
inflamed ; a small pimple is formed, which 
ulcerates and exposes the bony palate. If al- 
lowed to pass unchecked, the bone exfoliates, 
a connection is formed between the mouth and 
nose, the voice is most unpleasantly changed, 



114 NERYOUS EXHAUSTION". 

and an offensive discharge secreted. When the 
tonsils are affected, ulcers appear similar in ap- 
pearance to chancres. The soreness of the 
throat is not at first very severe ; there is mere- 
ly a slight tickling sensation when a crust or 
a.ny dry food is swallowed. But this, if un- 
checked, is one of the most severe forms of 
syphilis. The larynx is next attacked, on the 
top of the windpipe, and if not arrested will 
soon destroy life. Eruptions of the face and 
skin are one of the most common sequelia of 
syphilis treated mercurially. They make the 
skin thick, rough, and unequal ; the counte- 
nance acquires a livid hue ; the spots are gene- 
rally of a reddish, brownish, or copper color, 
and appear and disappear repeatedly. The 
following letter will illustrate the various effects 
of secondary symptoms : — 

"Albany, 1ST. Y., March 18. 
" Dear Sir — I am truly happy to inform 
you that all traces of that insidious disease 
with which I was so long afflicted have left me. 
I am now quite well ; shin quite clear from 
spots, throat entirely healed, and shin hones 
strong and entirely free from swellings. After 
being under so many medical men, I did not 



KERVOUS EXHAUSTION. 115 

think it possible you could have cured me so 
quickly. All I can do is to tliank you. You 
may publish the case if you think proper, so 
that all may be benefited. 

" I am, sir, yours faithfully and obliged, 

D. M." 

This gentleman was suffering from a compli- 
cated case of secondary symptoms ; he had 
been salivated three times, and consequently 
his system was saturated with mercury. Our 
first object was to eliminate the mineral ; sec- 
ond, to strengthen and invigorate the constitu- 
tion. The case occupied a period of nearly 
nine weeks. 



LECTTTKE VII. 

CERTAIN MEANS BY WHICH A CORRECT KNOWL- 
EDGE OE THE PATIENT'S CASE MAY BE OB- 
TAINED. 

The only certain means we can adopt for ob- 
taining a knowledge of the Patient's case is by 
testing the urine with our Newly-Constructed 
Microscope, with powerful Lenses. We 
are thus able to discover two most important 
points, by which our treatment is greatly in- 
fluenced. Firstly, we can ascertain whether 
the urine contains a portion of the seed — that 
is to say, whether in urinating there is a co?i- 
stant loss of the seminal fluid. Secondly, and 
of even greater importance, whether the ani- 
malculce or spermatozoa, of which the seminal 
fluid is principally composed, be endued with 
that vitality without which the semen is unfitted 
to perform its functions. In short, the micro- 
scope enables us to ascertain whether the seed 
le alive or dead. It need scarcely be observed, 
that when the seed is deficient in vitality the 
virile functions are greatly impaired, and the 
man soon becomes impotent as well as sterile. 



KERTOUS EXHAUSTION. 117 

With the aid of our microscope we can uner- 
ringly ascertain whether a discharge be from 
the prostate gland, from the seminal vessels, or 
from impure connection ; and many cases 
which have been improperly treated, as gonor- 
rhoea, for months, we have thus been enabled 
to cure in a week or ten days. It is our prac- 
tice to request patients in the country to send 
a small quantity of their urine for examination 
by means of the microscope. Any patient con- 
sulting us by letter will, therefore, enclose a 
two-ounce flat bottle, containing the urine 
passed on rising in the morning, securely corked 
and sealed, packed carefully in wool to prevent 
breaking, in a seidlitz box, which, with the flat 
bottle, may be obtained at any druggist's. The 
parcel may be addressed, carriage paid, 
Dr. L. J. Kah^, 

61 East 10th Street, New York. 

The patient is requested to be as minute as 
possible in the details of his case. Dr. Kahn , 
has also made arrangements by which his* medi- 
cines can be forwarded, safely packed and free 
from observation, to any part of the world. 



LECTURE VIII. 

OK SKIK DISEASES. 

Dr. Kahn has invited the attention of the 
public and of the profession to his important 
discoveries in the treatment of skin diseases ; 
and, although he cannot complain that his 
views have been neglected, still the subject is 
one of so great importance as to require no 
apology for enlarging upon it. We all know 
that for many years the remedies generally re- 
lied on in these cases were arsenic, mercury 
(corrosive sublimate), antimony, and caustic ; 
that medical men looked upon skin diseases in 
general (as too many, indeed, continue to do) 
as something to be hammered at, without much 
hope of relief, with all the most deadly drugs 
of the Pharmacopoeia. The almost invariable 
result was, and is, that even if the disease is 
cured, which is exceedingly doubtful, the con- 
stitution is ruined for the remained of the life. 
Let any man take up a medical work on skin 
diseases, and he will find, even now, that arsenic 
is looked on as the sheet anchor, and that hun- 
dreds of cases are reported in which arsenic 
succeeded in curing after all other treatment 



ITERYOUS EXHAUSTION. 119 

had failed. Now^ I have carefully, and for 
years, watched the results produced by this plan 
of treatment. I have always found it injurious. 
In many cases, after a time, there is a return of 
disease worse than before, and almost invariably, 
cure or no cure, I have found serious organic 
mischief affecting the heart or the lungs. I am 
here simply stating results — results which I 
have met with daily in a most extensive prac- 
tice. It is scarcely worth while to enter into 
causes ; for it is quite in accordance with com- 
mon sense that we should expect deadly poisons 
to produce deadly results. Why these particu- 
lar organs should be so affected is certainly of 
interest to medical men. Few diseases have 
been more minutely classified and described 
than the various forms of skin diseases, and it 
would be easy to enumerate fifty or sixty Latin 
and Greek names which have been applied to 
them ; but I fear the information would not be 
interesting to the general reader. For myself, 
I am in the habit of applying one general prin- 
ciple of treatment in all the varied forms which 
I see daily. My principle is simple enough and 
general enough to take rank as a great dis- 
covery. It is a principle I have acted upon in 
practice and have advocated in public for years, 



120 NERVOUS EXHAUSTION. 

and certainly my success has been most extra- 
ordinary. I will explain it in a few words. 
Let alone tre Skin Disease — Purify the 
Blood. 

Instead of classifying skin disease under ten, 
twenty, fifty, or a hundred heads, I find, as a 
general rule, they take rank under three, and 
that treatment must vary according to diag- 
nosis — still acting on the golden rule, " purify 
the blood." Skin diseases are: — 

1 st. — Hereditary. 

2d. — Of syphilitic origin. 

3 d. — Accidental, occasional, and anomalous. 
Hereditary Skin Diseases are, undoubt- 
edly, difficult to cure. The impure blood of 
the parent descends to the children. The re- 
sult is an intractable form of disease, and the 
only hope of cure is in steady, persevering 
treatment. Every globule of the blood is viti- 
ated from the very cradle ; and if the smallest 
trace of the impurity is allowed to remain in 
the system, all the labor is in vain, for the 
patient in a short time will be as bad as ever 
again. Hereditary skin disease is frequently 
consumption or scrofula in a rather milder 
form. There is no doubt in my mind of the 
intimate connection between these forms of 



HERVtms EXHAUSTION. 141 

disease. It is obvious that all local remedies 
must be of necessity ridiculous, and even dan- 
gerous. In fact, the best dressing, where there 
is great irritation, is a little cold or lukewarm 
water on lint. Above all, avoid greasy appli- 
cations or caustics. In this, as in other forms 
of skin disease, I am frequently consulted by 
those who have taken sarsaparilla for months 
or for years in large quantities, and desire my 
opinion as to the benefit to be derived from its 
use. My experience is that sarsaparilla in itself 
is practically inert in cold or in temperate 
climates. But it is perfectly wholesome and 
harmless ; it is a pleasant drink, and a decidedly 
nice vehicle for the administration of certain 
drugs. On the other hand, in tropical climates, 
or during exceptionally hot weather (as all 
through the summer of last year), sarsaparilla 
exerts a slight action upon the skin which is 
decidedly cooling and beneficial. In all forms 
of skin disease I attach considerable impor- 
tance to the use of the bath ; not that the 
theory of the water-doctors will satisfy — but I 
am willing to accept truth even from opponents; 
and certainly their plan approaches more nearly 
to the correct principle than the wholesale ad- 
ministration of poisonous minerals. I may add 



122 NERVOUS EXHAUSTION. 

that, applying the same remedies, I have been 
signally successful in my treatment of scrofula 
and consumption. Skin diseases of syphi- 
litic origin I have named as another great 
class of disease ; and certainly their importance 
entitles them to a rank apart. It is unnecessary 
in this part of the work to allude more particu- 
larly to their origin. Nor do I intend to in- 
clude what we may more properly class as 
"Secondary Symptoms." In cases of disease 
of the true syphilitic type there is always dan- 
ger that secondary and tertiary symptoms may 
ensue, especially when the patient is improperly 
treated and salivated by the imprudent admin- 
istration of mercury. But these cases are suf- 
ficiently obvious, and any mistake in their 
diagnosis is not probable, whatever there may 
be in their treatment. I make this observation 
because it unfortunately happens that in these, 
as in the primary disease, it is far too much the 
fashion to prescribe mercury. But skin dis- 
eases of syphilitic origin may occur many years 
after the original disease, and when, in fact, 
the cause is unthought of and forgotten. They 
are brought on by a taint, virus-poison, or germ, 
produced by the original disease, and which has 
remained dormant in the blood for months or 



NERVOUS EXHAUSTION. 123 

for years. I cannot tell you the reason. of this 
extraordinary phenomenon : I can only tell you 
the fact. But it is easy to give an illustration 
of the unexplainable effects produced by animal 
poisons. A man is bitten by a dog, perhaps so 
slightly as just to draw blood. The wound 
heals in a day or two, and the circumstance is 
entirely forgotten. But three months, six 
months, or (cases are recorded) even twelve 
months afterwards, he is seized with hydro- 
phobia, and death in a day or two is certain. 
So with syphilis: the poison may remain dor- 
mant for months or for years, and then, break- 
ing out, cause skin diseases of the most serious 
and intractable character. It is here important 
to remark, that it does not necessarily follow 
because a patient has suffered previously from 
syphilis, and is afterwards affected by skin dis- 
ease, that the disease is of syphilitic origin. I 
have been consulted by numerous patients, 
whose lives have been rendered miserable by 
groundless fears, and have found, on careful 
examination, no trace whatever of syphilitic 
taint. How is it possible to discover ? may be 
asked ; and my reply is, by one means and by 
one means only — and that is, careful chemical 
and microscopical examination and analysis ox 



124 NERVOUS EXHAUSTION. 

the urine. My treatment of skin diseases of 
syphilitic origin is precisely the same in prin- 
ciple as of skin diseases generally. It is neces- 
sary to bear in mind that the blood is affected 
by a specific poison or virus, which must be 
neutralized. Purify the blood, and the work 
is done. Accidental, Occasional, Anoma- 
lous skin diseases are such as arise without ap- 
parent cause; or they may result from errors of 
diet, hard living, exposure to the weather. I 
have frequently seen them as the result of bad 
provisions, impure water, &c, during a pro- 
longed voyage. Salt food is injnrious to some 
constitutions. To write at length on the vari- 
ous forms of disease which may be classed under 
the head anomalous would exhaust far more 
space than I have at command. It is obvious 
that in their treatment, even more than in other 
forms of the disease, my dogma is the only one 
consistent with common sense, truth and rea- 
son ; and even at the expense of being con- 
sidered prolix, I must again repeat, purify 

THE BLOOD. 

DR. KAHN'S BLOOD-PURIFYING TREATMENT 

Has now been used by the discoverer for a long 
series of years, Its action is purely upon the 



NERVOUS EXHAUSTION. 125 

bloody which it vitalizes, enriches, cleanses, and 
thoroughly purifies. The consequence is, that 
it is absolutely specific in all cases of skin dis- 
ease, no matter from what cause arising. That 
this is so isiproved by the undoubted testimony 
of thousands who have used it with unfailing 
effect during the last ten years. To prevent 
any possibility of disappointment, Dr. Kahn 
wishes it to be distinctly understood that it is 
necessary to continue treatment for a certain 
length of time. Skin diseases are in their na- 
ture intractable and difficult to cure ; and to 
promise a rapid and permanent cure with a sin- 
gle bottle of medicine would be to bring dis- 
credit upon it, however valuable. But the 
improvement will be found to be immediate, 
and no matter how serious or of how long- 
standing, the disease is certain to yield to a 
proper course of the system, which is destined 
to effect a revolution in the medical treatment 
of these cases, and is In truth the most impor- 
tant discovery in medical science since the 
introduction of vaccination by Dr. Jenner. 

Many persons, who have imagined themselves 
cured of the venereal disease, have had the 
misfortune to find the disease break out again 
six or seven years afterwards, A proof of this 



126 NERVOUS EXHAUSTION. 

happened in our practice lately. A gentleman 
was afflicted with the complaint, and was cured, 
as he thought, by the advice and prescriptions 
of an eminent surgeon. He afterwards married; 
a few months after which he caught a severe 
cold, which terminated in a sore throat. He 
applied to a medical man, who prescribed the 
usual remedies, but entirely without success. 
Haying been advised to consult us, he called 
upon us, and after a careful investigation, we 
informed him it proceeded from an old vene- 
real complaint. It was some time before he 
would admit this to be the fact, and he perse- 
vered with the old remedies nearly a month 
longer, till at length the disease became so 
serious thct he was compelled to place himself 
under our care ; the rapid improvement under 
our treatment was sufficient proof of the truth 
of our diagnosis. We therefore recommend 
extreme care that the disease be thoroughly 
eradicated from the blood ; for this purpose 
our medicines are very generally employed, and 
will be found most valuable, particularly in the 
after consequences, in removing all corruptions, 
contaminations, and impurities from the vital 
stream, searching out the morbid virus, and 
radically expelling it through the skin, 



APPENDIX. 

EX TABULIS ^GKOTORUM MEIS. 

{Selections from my Case-Booh.) 

In adding these cases, I may be permitted to 
observe that they are selected, not because they 
are the worst which have come under my obser- 
vation and treatment, but as being interesting 
to the general reader, and as containing some 
point likely to be useful as an example. These 
cases are correct in every particular, they are 
true to nature, and are a fair sample of those 
which I am, and have been for years, in the 
daily habit of meeting with in my extensive 
practice. That my success in treatment has 
been so uniform, I attribute (under Providence) 
to my extreme care in diagnosis, and to my use 
of purely natural remedies, eschewing those 
dangerous mineral poisons so entirely depended 
on by the general practitioner. It is not my 
intention to add to these cases in future editions 
of this work. Inviolable secrecy is the rule 
of my practice, and may always be relied on. I 
have never yet published a case, excepting with 



128 NERVOUS EXHAUSTION. 

the express permission of the patient, and fre- 
quently at his request ; and the initials em- 
ployed are arbitrary. 



IMPOKTANT NOTICE. 

Patients are informed that no case is pub- 
lished in this work without the written con- 
sent, AND GENERALLY AT THE REQUEST, of the 

iudiyidual referred to ; and the most invio- 
lable SECRECY MAY BE FAITHFULLY RELIED 

on in all communications. 

Case 1,787. 

" New Orleans. 
" Sir — A perusal of your excellent work has 
induced me to hope you will be able to render 
me some assistance ; I accordingly feel the 
greatest confidence in submitting the following- 
case for your opinion and advice. I am twenty- 
four years of age. At the age of fifteen I was 
induced to indulge in the habit of self-abuse, 
which I practised unremittingly once or twice 
a day for six years. Though I have entirely 
given up the practice for the last two years, I 
am, however, suffering from its cruel effects. 



XERV0US EXHAUSTION". 129 

During the time above mentioned I led an ex- 
tremely regular life, never drank much spiritu- 
ous liquor, nor had I intercourse with females. 
In fact, so timid was I that I had not courage 
enough to address a woman on the subject. I 
was remarkably short and slender ; and every 
morning when I. awoke, a yellowish matter 
which had issued from my mouth during the 
night stained the pillow. I constantly com- 
plained of determination of blood to the head 
and of great nervousness. My sight and mem- 
ory began to fail me. I felt pain over the 
abdomen after each act, but was still ignorant 
of the enormity of the vice and of its dire 
effects. In the spring of 1867, whilst at church? 
I had a rush of blood to the head, and fainted. 
I was brought home and had leeches applied to 
the back. The medical attendant hinted at the 
practi ce of self -pollution as the cause of the 
affection. This opened my eyes to the truth, 
though I concealed it. My sufferings, mental 
and bodily, now became dreadful. My inteK 
lectual faculties became entirely confused. J 
now became a mere skeleton. My eyes were 
quite dead, and bluish streaks were perceptible 
below my eyelids. I constantly staggered in 
walking, and frequently was near falling. I 



130 NERVOUS EXHAUSTION. 

had constant dizziness in the head, and a host 
of symptoms, principally from the head, for 
which no one could account. From shame, I 
did not reveal my condition till, being affected 
with a pain in the chest, I consulted a medical 
man, and was somewhat relieved. My accu- 
mulated sufferings now brought on a profound 
melancholy. Travelling being now recom- 
mended, I came up to New York, where change 
of scene and plenty of exercise have worked a 
great improvement in my condition ; still, how- 
ever, I have severe sufferings, which I beg leave 
to enumerate to you. I have involuntary 
emissions of semen both when asleep and when 
awake, in the company of females or before a 
fire. I am affected with constant dizziness in 
the head. My sense of hearing as well as that 
of sight is impaired — a sort of mist before my 
eyes — a kind of undulating pain in the chest. 
I am entirely incapacitated for sexual inter- 
course. A constant feeling of terror is con- 
stantly hanging over me. Such is as accurate 
an account as I can give of my present and 
former state ; may I therefore solicit your im- 
mediate reply to my distressing case ? 
" I am, &c, &c, 

"W. R. T." 



NERVOUS EXHAUSTION. 131 

Remarks. — If ever a subject presented him- 
self for exemplifying all the dire effects of self- 
abuse, it was this individual. The order, too, 
in which the disastrous consequences of this 
habit were observed to follow each other, is 
very remarkable, and in perfect accordance with 
the pathological principles advanced in the 
previous part of this work ; in fact, this one 
case would serve as an illustration of all we 
have said on the subject. First, the patient 
was observed to be remarkably short and slen- 
der. Here we see how the practice of self- 
pollution, by disturbing and destroying in the 
first instance the functions of digestion, im- 
paired the growth and nutrition of the body. 
The next ravages committed by it were on the 
nervous system, and first on the brain; the 
sense of vision being impaired was a conse- 
quence of this ; the disturbance of the nervous 
system was also evinced by the determination 
of blood to this organ. The failure of memory, 
too, and of all the intellectual faculties, the 
state of melancholy, so perceptible in this case, 
are further proofs of the destructive influence 
of this habit. Kor was the brain the only part 
of the nervous centres affected : the spinal 
system also became deeply implicated, as proved 



132 NERVOUS EXHAUSTION. 

by the wandering pains in the chest and over 
the abdomen ; the staggering gait of the patient, 
the state of muscular debility into which he 
was thrown, the involuntary seminal discharges, 
the total inability of the patient to perform 
the generative act, are still further instances of 
the melancholy effects of the habit of mastur- 
bation. 

After impressing on this patient the absolute 
necessity of abandoning this habit, which, ac- 
cording to his own account he had himself done, 
Ave undertook the treatment of the case ; and 
by prescribing such medicinal and dietetic rules 
as the complicated nature of the patient's con- 
dition seemed to require, we succeeded, in about 
two months in restoring the patient to the en- 
joyment of perfect health. 

Case 1,615. 
Eangoon, January 20th, 1868. 
Sir — I find myself constrained to fly to you 
at last, and reveal a secret which I can no longer 
keep to myself. You will readily understand 
what it is, although I am filled with shame and 
confusion to acknowledge it even to you. But 
I feel assured thro^.ng myself into your hands 



tfEKYOUS EXHAUSTION. 133 

alone will save me, and render me happy as a 
man in this world. 

I am one of those unhappy beings who early 
fell a victim to that pernicious an I accursed 
habit, self -pollution, which has already rendered 
me impotent, and it will not be long, perhaps, 
before its symptoms exhibit themselves in all 
their severity upon me. Would to God that I 
had never known this soul-destroying crime. 
How happy had I been if, even after knowing 
it, I had that moral restraint upon myself to 
check it, as a rational being and a Christian 
ought to do. I was let into knowledge of this 
forbidden habit (I curse the day it was) at such 
an early age as fourteen. I am now entering 
upon twenty-four, and it will be as superfluous 
as unnecessary for me to tell you to what state 
these nearly ten years' indulgence in this nefa- 
rious act must have reduced me. You can 
divine that yourself better than I can describe. 

Your little work, which fell into my hands, 
providentially I think, soon convinced me of 
my imprudence, and awakened me to a true 
sense of my position, and made me look, as 
if with a new eye, upon the blackness of this 
vice, which I have at last given up, I hope 
forever, 



134 NERVOUS EXHAUSTION. 

The long continuance, however, played all 
the misch ief imaginable upon me. My health 
visibly gave way to it. My memory fails me, 
and is no faithful companion of mine to trust. 
My mind is daily sinking into a state of stupe, 
faction, and is unwilling or unable to exert it- 
self, and my strength is so prostrate that I feel 
an utter aversion to all bodily exercise. 

Yet to all outward appearance I look hearty 
and strong, being corpulent ; and none, I think, 
would suspect me as addicted to this vice, un- 
less, indeed, a keen observer discover it, if that 
be possible, in my eyes, which look vague and 
dull. It appears to me strange that, unlike 
many who were subject to this vitiating habit, 
I have ample hair about my face, thick mous- 
taches coming on my upper lip, and have ample 
and thick whiskers ; I feel no particular pain 
about back or loins worth mentioning. My 
bowels are generally costive, testicles pendulous, 
and penis rather short than of ordinary length. 
I get emissions at night, on an average of per- 
haps once a month. 

These, sir, as I describe to you, are the symp- 
toms as appear to me. I do not know by what 
wonderful providence I am still kept to look 
like a man, although without the essence or 



KERTOUS EXHAUSTION. 135 

attribute. I can .only fly to you at this ex- 
tremity, and look upon you, next to the 
Almighty, as one who alone can restore and 
give back to me all that I have brutally and 
ignorantly lost. I have not been in circum- 
stances till now to apply to you for help and 
cure ; and what I can at present afford I send 
you for your priceless and invaluable remedies, 
the taking of which only could, I am confident, 
make me whole and renew my happiness. 

Give, sir, I beseech you, such attention to the 
case of one who throws himself into your hands 
as the severity of this disorder merits, and who 
will consider and respect you next to his God 
for the cure which cannot be got elsewhere in 
the world but in your hands. Please be good 
enough to see the medicines you send me well 
packed, so that the rough usage they will meet 
with may not damage them. It will be also 
esteemed a favor, your letting me know your 
opinion. All your instructions will be thank- 
fully and gratefully obeyed. Aw r aiting your 
reply with greatest anxiety, I beg to remain 
sir, your obedient servant. 

Please address me thus: To Mr. . care 

of , Kano-oon, Burmah. 



136 NERVOUS EXHAUSTION. 

Kemarks. — This gentleman required active 
treatment for a period of four months. He 
was thoroughly and effectually cured, and has 
since returned to the United States and married. 
A few months since I received a letter announc- 
ing that his wife had been safely delivered of a 
fine boy. 



Case 3,765. 

San Francisco. 
A clergyman, about thirty years of age, con- 
sulted me not long ago in reference to genera- 
tive debility, arising from habits, the ultimate 
results of which were unforeseen, but now suf- 
ficient to embitter existence. About three 
months previously to the date of his first appli- 
cation to me, he married, and much to his sur- 
prise and mortification, had been unable to 
consummate the ends of that institution, in 
consequence of premature and involuntary emis- 
sion invariably preceding the attempt, and thus 
destroying sexual power. After waiting a few 
weeks, he became painfully convinced that 
without interference this state would become 
permanent ; and in his intercourse with me I 
elicited the fact that, when a schoolboy, he was 
initiated by some of his precocious fellow-pupils 



2STEBV0US EXHAUSTION. 137 

into the habit of self-pollution. This, indeed, 

became truly a habit, from which he dreaded 

no ill consequences, excepting from its too 

frequent repetition, and generally twice a week 

by manual friction he was accustomed to seek 
tnat iuv., ^ , . , , . . ■ 

natural on ^^^e sexual propensity is the 

feared the loss of power, tffi&g£ at he . never 

haunted by ill-defined nervous indigestionftiSz 
true cause of which never occurred to his 
thoughts, and the absence of all apprehension 
arose from the supposed consciousness that he 
never lashed these organs to efforts for which 
they did not appear perfectly prone and capable. 
Xow, however, the tendency of this injurious 
habit flashed upon his conviction in all its terri- 
ble reality. It appears that during ten years 
previously to his marriage he had been the sub- 
ject of nocturnal emissions occurring irregu- 
larly, but generally once in every week or ten, 
days ; but to this he was accustomed to attach 
not the slightest importance, under the idea 
that the discharge was perfectly natural, and in 
no way connected with the habit of his boyhood. 
The consciousness of his impotence, and the 
perception of its cause, preyed upon his mind 
jso as to render him completely wretched, unfit 



138 NERVOUS EXHAUSTION. 

not merely to reciprocate the interchange of 
domestic and matrimonial felicity, but un- 
nerved for all the purposes of serious thought, 
and the high duties of his sacred vocation. In 
full possession of the facts of the case, and 
having secured his unlimited confide^;^ 
mencedthete^tm^^^j^ of cold agtrin . 

ml pJ> vvashes to the enfeebled organs, with a 
view to destroy the morbid irritability. Con- 
joined with this, he steadily persisted during 
two months in my course of alterative and tonic 
remedies, maintaining a resolute abstinence 
from all attempts at sexual gratification during 
that period. 

The primary effects of these restorative agen- 
cies was the entire sttppression of nightly emis- 
sions; and at the end of seven weeks desire 
became so ungovernable, that, attempting in- 
tercourse, my patient had the happiness to find 
the healthy and natural action of the genera- 
tive organs entirely restored ; a circumstance 
that in itself tended, by its effects upon his 
joyous mind, to maintain their newly acquired 
power. I received a letter from him a month 
afterwards, conveying the grateful expression 
of his warmest thanks ; and I had afterwards 



NERVOUS KXHAtTSTXOK. 1S9 

the satisfaction to perceive, from an announce- 
ment in the newspaper published in the locality 
in whi«h he resides, that he has become a parent. 
doubtless very much to the mutual satisfaction 
of himself and the partner of his affections. 



Case 1,900. 

Albany, N". Y. 

With the permission of a gentleman, whose 
introduction professionally to me has termi- 
nated in the formation of a lasting friendship, 
I transcribe such portions of one of his letters 
as will illustrate his position on his first appli- 
cation to me for advice, and the results of my 
treatment. He observes: "From my earliest 
youth I have manifested a susceptible tempera- 
ment, highly and easily excitable, and, in ref- 
erence to the sex, the long-suffering victim of 
passions which I never sought to control. An 
ardent imagination was the bane even of my 
school-days, and, in the society of youths, over 
whom, as well as myself, no vigilant eye was 
watchful, or perhaps evaded, I gave loose to 
the indulgence of each prurient emotion as it 
rose ; while feebleness, loss of appetite, and 
the incipient symptoms of consumption resulted 
as the disregarded indications of violence, un- 



140 NERVOUS EXHAUSTION. 

naturally inflicted upon 7)iy debilitated powers 
through self-pollution. I was always accounted 
what the world calls 'nervous,' and, under the 
hope of recruiting my shattered constitution, 
and that I might no longer be tempted to seek 
for gratification in unhallowed propensities, / 
determined to marry. My partner (since de- 
ceased), and lately the mother of my only child, 
was every way worthy of manly choice, and in 
the first impulses of passion, and until the 
charm of novelty was destroyed, I underwent 
no uneasiness from the failure of sexual power. 
This state of things did not last long. Anx- 
iously hoping for offspring, and feeling hourly 
that some strange change had befallen me, the 
dreadful truth flashed upon my tortured con- 
science, and I felt that the excesses of youth, 
though of slow retribution, were dreadfully 
sure and painful in maturer age. And now the 
long train of *my nervous ailments darkened 
around me with tenfold severity; my wife's 
very silence reproached me with more keenness 
than open recrimination ; I cursed my very 
being, or rather the weakness that had rendered 
me the victim of that early and horrible delu- 
sion. I doubted of my powers, weakened as 
they truly were, till the very doubt ensured 



KEEYOrS EXHAUSTION. 141 

their incapacity ; despair, self-loathing, and an 
apparent cureless melancholy invested the first 
years of manhood with gloom, and the pros- 
pect with hopelessness ; as to the gratification 
of my wish to perpetuate my name, that I had 
long resigned as a well-merited impossibility. 
My ordinary medical adviser either did not or 
would not understand me, and was fain to 
treat the ailment which evidently distressed 
all around me upon principles which (knowing 
he was ignorant of the true cause of such suf- 
fering) only could tend to aggravate the mis- 
chief. Under these circumstances, as I confess 
with much reluctance, and with not the sligh- 
test hope of benefit, I ventured, first anony- 
mously, to consult you by letter. The tone of 
your letter emboldened me to make a personal 
application, and confidence and respect became 
mutual ; your manner riveted that confidence, 
and from that hour I found a friend, who has 
inspired the gratitude every man must feel who 
has been rescued from the cold and cheerless 
jaws of destruction. I followed your remedies, 
I implicitly adopted your general advice, and 
incipient improvement kindled hopes as to the 
ultimate result, which has been most happily 
realized. I shall not easily forget the feeling 



142 NERVOUS EXHAUSTION. 

with which my first-born was placed in my 
arms. Death has removed her, with whom, 
but for the circumstances previous to our union, 
I might have passed, in the first years of married 
life, a happier time ; at least I feel the returned 
possession of vigorous manhood, my nervous 
apprehensions of incapacity are scattered to the 
winds, and the bitterness of her loss is miti- 
gated in no trifling measure by the conscious- 
ness that she saw and hailed my returning 
health before I was deprived of her forever." 



Case 3,765. 

Brooklyn. 

Sir — Accept equally my gratitude and hom- 
age to your skill. I assure you it gives me in- 
finite pleasure to report progress in accordance 
with your request; it is now just four weeks 
since I commenced with your course of medi- 
cine. 

During the night of the loth November, I 
had an emission ; on the l&th your medicine 
came to hand. / have had one emission since — 
during the night of the Hth of December; twenty- 
one dear days. 

The first time I took the medicine I felt it 
beneficial, but the pills have had a strikingly 



XERYOUS EXHAUSTION. 143 

wonderful effect ; after taking them I feel so 
well, so happy, so full of joyous spirit, that I 
am like a holiday schoolboy next day. 

I must tell you that my health and strength 
are wonderfully increased ; my duties, so 
wearisome before, are new light and easy. I 
work and never lose my energy, or become 
wearied. In short, I have lately felt that life is 
a pleasure. Day by day I have felt better. 
My friends, public and private, are surprised 
to see me so well, so strong ; I am most san- 
guine of future health and manly strength. 

I thought the emission would never occur 
again ; imagined myself perfectly cured. How- 
ever, the last emission was only slight, but I 
felt weak in my knees, and had a feeling of 
exhaustion for all the day after; but it went 
off, and I felt well and strong again, and still 
continue so. 

The penis has assumed a much larger appear- 
ance, and feels more natural and vigorous ; it 
has lost that flabhiness, feels warm, and is 
never clammy. I begin to feel the natural 
geniality of the organs. I have rigidly adhered 
to your rules and advice ; the glutinous matter 
does not now escape with my urine ;'my bowels 
have been costive and irregular. 



144 STEKY0US EXHAUSTION. 

My sudden acquisition of strength surprises 
me; the dreams are not so frequent, nor so 
lascivious. Will the emission be altogether pre- 
vented? Shall I endanger my health by marry- 
ing in twelve months' time ? Will the rules 
you have given be necessary: I mean with re- 
gard to diet, sponging, exercise, sleeping, &c., 
after I am 7nedicinally cured ? 

I already hail you my regenerator. 

Anxiously awaiting a reply, permit me to re- 
main, with grateful feelings, 

Your obedient patient, 

L. D. K 

To L. J. Kahst, Esq., M.D. 



Case 2,190. 

u Milwaukee. 
" Deak Doctok — Haying been an eye-witness 
of the extraordinary success of your treatment 
in the case of a friend of mine, who was re- 
duced to the last stage of debility in conse- 
quence of his indulging in the habit of Onanism, 
and being myself a victim to the same vicious 
indulgence, I have summoned sufficient courage 
to make application to you to solicit the benefit 
of your skilful advice. For the last ten years 
I have indulged in the habit, on an average, 



KERVOUS EXHAUSTION. 145 

five or six times every week ; the consequences 
have been very marked and striking. I am at 
present very much debilitated, and wasted 
away in flesh. My appetite is become extremely 
bad, though at first it became actually vora- 
cious after I first commenced the practice. I 
can with difficulty digest the lightest food ; my 
limbs are extremely feeble, and I never feel by 
any chance the least desire for sexual inter- 
course ; indeed, such an idea never enters my 
head, though at the age of sixteen I was rather 
forward in that particular. I am also unable 
to apply my mind for any time to any one train 
of thinking ; and as for memory, I have 
scarcely any. I also labor under an inconti- 
nence of urine ; and, both during sleep and 
when at stool, I am troubled with seminal dis- 
charges. Under this state of things, I applied 
some months ago to a medical practitioner of 
some repute in this place, but after taking 
medicine to no end, as prescribed by him, I find 
not the least improvement in my condition. I 
have, since reading your book, almost entirely 
discontinued the ruinous habit which has been 
the cause of all my sufferings and sorrow ; yet, 
so inveterate has been my addiction to the 
habit, that I am still dragged into the gratifi- 



146 NERVOUS EXHAUSTION. 

cation of it, — but very, very rarely. I find my 
intellect sometimes in a very strange state ; in- 
deed, to be candid, I am sometimes afraid my 
reasoning faculties are more or less impaired. 
I trust this exposition of my present feelings 
and state of health will lead you into a knowl- 
edge sufficient to enable you to undertake my 
case. My sole hope of ever becoming a mem- 
ber of society rests on you. The friend of 
mine who directed me to you is now so per- 
fectly re-established in health and strength, 
that I entertain strong hopes that my case is 
not entirely desperate. Certainly he was not 
so bad as I now am. 

" May I beg of you to take my distressing 

and pitiable case into your consideration, and 

to send me word what I must do. Hoping to 

hear from you as soon as you conveniently can, 

"I am, Sir, yours respectfully, 

"S. M, 

"To Dr. Kahn." 

"Milwaukee. 

" Dear Doctor — To state to you in adequate 

language the grateful sentiments I feel towards 

you for the state of health and strength to 

which you have restored me,- would be out of 



KERVOUS EXHAUSTION. 147 

my power. I thought such a thing beyond the 
power of medicine. Oh ! sir, what a difference 
in my present state of vigor and of mental 
quiet from what I was in but three months 
since. All that time I was a wretched, debili- 
tated, and emaciated being, ashamed and de- 
graded in my own eyes, from a consciousness 
of having been the cause of my own degrada- 
tion. ISTow I can hold up my head like a man, 
can feel like a man, and have good reason to 
know that I can act like a man — for which I 
am in a fair way of being made parentally to 
pay. I would like to know whether it will be 
necessary for me to continue the use of the 
medicine any longer. The small bottle in the 
last packet seemed to be a clincher. It w r ound 
up all my energies, like the works of a clock. 
In fact, it seemed to act on me like magic. 

" I beg to return to you my w r armest thanks 
for the patience you have had in listening to 
my many tales of woe, and restoring me to the 
possession of the happiness I now feel. 
" Believe me, 

Yours, very gratefully, 

"S. M. 

"To Dr. Kahx." 



148 NERVOUS EXHAUSTION. 

Case 2,927. 

"New Jersey. 

" Sir — One of the most pitiable objects that 
ever addressed you now claims your mercy and 
attention. 

" I am now twenty-four years of age, but 
sadly debilitated. I no longer approach a 
woman. I feel satiated or disgusted with the 
sight of one — my appetite is nearly gone — my 
digestive powers are greatly impaired — and I 
feel no interest whatever in what is passing 
around me ; and what is still stranger, the hair 
of my head has fallen off in a great measure, 
so that I am almost bald — strangers take me 
for forty years of age. Having perused your 
book very lately, a ray of hope darted through 
my mind that I might find some relief in your 
judicious treatment. Can you do anything for 
me ? In the hope that you will undertake my 
case, I enclose you your fee of $5, which shall 
be repeated when necessary ; only do not delay, 
I implore you, in writing to me. My only hope 
is now in your skill and experience. If that 
fail me, I have not a hope left. Do, then, take 
pity on me, as I am nearly broken-hearted. 
" Your unfortunate correspondent, 

"Dr. Kahn," "A. B. C. 



HERVOUS EXHAUSTION. 149 



"New Jersey. 

"Dear Sir — In my last communication I 
stated to you that the most unfavorable of the 
symptoms were gone ; that my appetite was re- 
established ; the seminal discharges in my sleep 
and at stool, were gone ; and that my 
strength and energy were perfectly re-estab- 
lished. I have now the pleasing duty to state 
that my baldness is very much diminished, so 
that I have given up the idea altogether of wear- 
ing a wig. My desire for sexual intercourse is 
perceptibly returning, so that I now stand a 
fair chance of being a better man than I ever 
was. Oh, sir ! what a lesson I could read to 
those unfortunate youths who indulge in ex- 
cessive venery at a .premature period of youth. 
How dreadful have been my sufferings of both 
mind and body. Thanks to your unremitting 
and assiduous care, however, my health is now 
better than I remember it ever to have been. 

"I should very much like to have another 
packet of your medicine, as I am obliged to go 
a considerable distance from home in ten or 
twelve days hence, and shall not return for 
three months. Any advice you may consider 



150 HERVOUS EXHAUSTION. 

necessary you will be kind enough to impart to 
me in your next. 

" I am, Dear Sir, your grateful patient, 

"A. B. 0. 

"Dr. Kahnt." 



Case 3,759. 
A threatening of Pulmonary Consumption from 
excessive Venery. 
M. W., aged twenty-five years, of rather deli- 
cate frame, a clerk in a large commercial estab- 
lishment, had been always of very regular habits 
in every respect — had been residing in one of 
the outlets of New York for the last two years, 
and, about twelve months before we saw him, 
he married a young widow in whose house he 
had been lodging, and continued to indulge 
very freely in the pleasures of the marriage-bed 
for the first nine months without feeling any 
bad effects ; about this period, however, he be- 
gan to lose flesh very perceptibly, and to feel 
great lassitude on the least exertion ; his appe- 
tite for food also began to fail him ; his sleep 
became disturbed and unrefreshing, bowels be- 
came constipated ; in fact, all the symptoms 
indicating a general deterioration of all the 
functions, both bodily and mental, began to 



NERVOUS EXHAUSTION. 151 

show themselves ; his **'ght became impaired, 
as also his mem^T ; in fact, his mind was so 
absorb^ 1 m ^ ne one engrossing idea, namely, 
jnat of the gratification of the venereal appetite, 
now increased beyond all bounds, that he be- 
came unable to devote the proper degree of at- 
tention to his ordinary occupation. He now 
also began to complain of pain in the upper 
part of the right lung, and of considerable 
difficulty of breathing on ascending an emi- 
nence; these symptoms having continued for 
two or three weeks, he began to perceive a sense 
of heat in the top of the fauces, as also a saltish 
taste in the mouth, a little after which he be- 
gan to spit blood of a florid red color and frothy 
appearance. Being alarmed at this, and having 
for some time suspected that the cause of his 
present impaired health was his inordinate in- 
dulgence in venery, he called on us, and de- 
tailed the history of his case, as w r e have now 
given. On examining his chest we observed 
some dullness on percussion in the upper por- 
tion of the right lung, immediately under the 
clavicle ; the respiratory murmur was also ab- 
sent from this part ; in every other part of the 
chest the respiratory function seemed all right; 
the action of the heart was somewhat irregular, 



152 NERVOUS EXHAUSTION. 

being very much hun^d occasionally, and 
from the slightest cause. 

We directed that he should forth witn -v^tain 
from all sexual intercourse instanter, a con- 
dition imperatively required for the re-estab- 
lishment of his health ; we also prescribed a 
peculiar diet, and such medicines as the nature 
of the case seemed to indicate. After being 
about three weeks under treatment, he began 
perceptibly to recover his strength, his appetite 
returned, as also his sleep, the pulmonary 
symptoms gradually declined, the haemoptisis 
had not returned after the first week he had 
been under our care, the pulmonary tissue was 
now perfectly pervious to air, and percussion 
elicited the natural healthy sound over the 
chest ; in fact, after being under treatment, in 
all about six weeks, he was entirely restored to 
health. Apprehensive, however, lest he might 
return to his former inordinate indulgence, we 
recommended his leaving New York for a 
month or so and returning to his native place, 
which was in some part of Jersey ; he has done 
so, and it is but a few days ago since we re- 
ceived a letter from him announcing the perfect 
restoration of his health and strength, and his in- 
tention of resuming his former employment. 



HEftTOtS EXHAUSTION. 153 

Remarks. — This was a case where conside- 
rable difficulty presented itself ; a patient ex- 
hausted in strength, with a very serious affec- 
tion of the lung, for the relief of which de- 
pleting measures appeared necessary. It is 
evident, however, that if such treatment was 
carried to any extent in this case, the patient 
must sink ; thus, then, we had to restore 
strength, and, at the same time, to combat in- 
flammatory symptoms of rather an alarming 
nature. By closely watching from day to day 
the effects of our remedies, we finally succeeded 
in gradually restoring the strength, and at the 
same time in keeping down inflammation by 
the local application of counter-irritants. 



Case 1,387. 
A. E. M. , about twelve months before seeing 
us had contracted gonorrhoea from a casual 
connection. A slight discharge and scalding 
made their appearance about seven days after 
the intercourse. The age of this gentleman 
was 32, and although he had led a very free life, 
he had never before contracted disease. His 
occupation was head-salesman and manager of 
a large mercantile house ; his pursuits active ; 
he was a man of great energy, clever in busi- 



154 KERVOUS EXHAUSTION. 

ness, well educated, and of social habits ; un- 
married ; temperament nervous-sanguine. Of 
course he knew very well what was the disease, 
and without loss of time consulted a physician, 
a friend of his, in large practice. Wishing to 
cut short the disease as soon as possible, the 
doctor ordered large doses of balsam copaiva 
and cubebs, and also applied an injection of 
nitrate of silver. These active measures seemed 
at first to produce the desired effect. The dis- 
charge, which had never been very copious, was 
decidedly lessened ; but the patient complained 
somewhat more of the scalding and pain in 
urinating. The treatment was continued a 
few days longer, but the discharge remained 
and the pain increased. He also found con- 
siderable irritation of the bladder — so that he 
was unable to hold his urine for any length of 
time. There was also much heat and inflam- 
mation about the penis, and small red pustules 
began to make their appearance on the body, 
causing intolerable irritation. The appetite 
was lost, and, in addition, whateve was eaten 
caused sickness and indigestion. The stomach 
revolted entirely from the medicine, which, 
when taken, was immediately rejected. His 
friend now discontinued treatment, and ordered 



NERVOUS EXHAUSTION. 155 

warm baths and mild aperients. Some six or 
seven weeks had gone by, and A. E. M. found 
himself, as far as the disease w r as concerned, 
certainly no better, but in addition greatly re- 
duced in strength, and his digestion so seriously 
impaired that his stomach could not bear any- 
thing in the shape of medicine. A temperate 
drinker before, he had entirely given up all his 
usual stimulants, having been so advised by his 
friend. For a w r eek or tw 7 o longer, sometimes 
a little better, at other times a little worse, he 
still continued taking medicine when he could 
stand it, occasionally trying a mild injection. 
The discharge w r as thick and greenish in color, 
scanty in quantity — the nut of the penis and 
the lips of the urethra blood-red. The pain in 
urinating now became extreme, and one day, 
having been much on his feet, he found, to- 
wards evening, that he was compelled to pass 
urine every five minutes. He had been suffer- 
ing from severe pain in the back all through 
the day, and he felt himself so ill that he im- 
mediately undressed, w T ent to bed, and sent for 
one of the first surgeons in the city of New 
York. It proved that inflammation of the 
bladder had set in, and so much had the patient 
been reduced, and so obstinate was the case, 



156 NERVOUS EXHAUSTION. 

that it was three months before he was able to 
rise from his bed. But A. E. M.'s troubles 
were not yet ended. After the inflammation 
was reduced, a very copious urethral discharge 
came on, which the surgeon very properly en- 
couraged by every means in his power. It now 
became important to endeavor to stop this dis- 
charge, which was attempted carefully and ten- 
tatively. Just as it was stopped, and the pa- 
tient was congratulating himself that his dis- 
ease was cyred, the left testicle began to swell, 
and so great was the pain and inflammation, 
that he was again obliged to take to his bed. 
Another month, when the other testicle was 
attacked. The treatment adopted was leeching, 
cold lotions, and aperients. It would be tedious 
to continue the history of this case. Suffice it 
to say, when we were consulted we found con- 
siderable discharge, which, directly it was 
checked, caused immediate swelling of one or 
both testicles, obliging the patient to lay up, 
the slightest exertion or exercise causing intole- 
rable pain. What was to be done ? I must 
confess this case required deep consideration, 
and, when I heard the history, I felt some mis- 
givings as to the result. At first I thought it 
possible that some complication in the form of 



NERVOUS EXHAUSTION. 157 

seminal discharge might be present ; but a 
careful microscopic analysis convinced me that 
such was not the case. The discharge was 
purely gonorrhoea!, and although so long a time 
had elapsed since the infection, strange to say, 
there was no stricture. Seeing that the patient 
was so much reduced, I determined to act 
against all the usual laws of medical men in 
the treatment of generative inflammation and 
urethral discharges. I prescribed powerful 
tonic treatment, and ordered in addition at 
least two bottles per diem of the best London 
porter. Although the discharge was copious, 
and the pain in urinating very severe, so much 
was the patient reduced and weakened, that I 
determined at all risks to improve his general 
health and condition, even if the local disease 
were thereby increased. But such was not the 
result. I saw him daily, and from the first 
hour improvement set in. The diet and medi- 
cine together caused a visible alteration from 
day to day. At the end of a week all pain in 
urinating, and all tendency to inflammation, 
had left him. During a month the character 
of the discharge gradually changed, and, 
though no special remedies were employed, the 
quantity greatly diminished, I now found the 



158 NERVOUS EXHAUSTION. 

patient well enough to attempt cautiously to 
stop the flow. In this I succeeded in ten days, 
keeping up the medicine a week or so longer, 
lest there should be a return, though I did not 
fear it. But everything went on well, and I 
discharged A. E. M. thoroughly cured, and in 
a perfectly sound, healthy condition, within 
six weeks of his first consultation. From that 
day to the present time there has been no re- 
turn of the disease, and no unpleasant symp- 
toms whatever. 

Eemarks. — It is very frequently supposed, 
especially by young men, that gonorrhoea is a 
disease of little or no consequence. There is 
no doubt but that occasionally a cure may be 
very easily effected. On the other hand, there 
are constitutions to which one dose of the reme- 
dies which are so generally used will act as a 
virulent poison. To discriminate one from the 
other requires the acute instinct of the educated 
medical observer. In my hands the "abortive" 
treatment of gonorrhoea, by which a cure is 
frequently effected within three days, has 
proved invariably successful. Why ? Because 
I never attempt it, except in cases which my 
experience tells me are amenable to that vigor- 
ous treatment, And surely it is better to take 



KERVOUS EXHAUSTION. 159 

a week to cure, if necessary, than adopt treat- 
ment nearly certain to fail, and which must, in 
case of failure, protract the disease for a length- 
ened period. Another week of the "usual 
remedies ' ' must have cost A. E. M. his life, 
and when I first saw him I did not feel by any 
means certain that I could restore him to health. 



Case 4,798. 

" Boston, Mass. 
" Sir — The critical and pressing circum- 
stances in which I find myself placed oblige me 
urgently to solicit your immediate attention 
to this my communication. I shall give as 
briefly as possible the history of my case. I 
am now in the forty-fifth year of my age, and 
have never been married. I begin to find my- 
self less vigorous in my embraces, and less in- 
clined, because less able, to repeat them. I also 
experience pains in the lower part of the spine, 
gleety discharge, occasional dizziness in the 
head, and, when at stool, emissions of semen. 
At first, and for considerable time, I took no 
notice of these things, and did not at all sus- 
pect the causes which could have given rise to 
them. I happened, however, to read in a medi- 
cal work, some time since, an allusion made to 



160 NERVOUS EXHAUSTION. 

these symptoms which I have stated that I felt, 
and some (certainly obscure) reference to im- 
perfect coition and premature secession from 
the female as their probable cause. I then 
consulted your book, and found that the real 
cause of my symptoms, which have since, by 
the way, become much aggravated, was to be 
referred entirely to the habit in which I had 
been for so many years indulging. As I wish 
to be as minute as possible in this my commu- 
nication to you, I find brevity impossible. I 
therefore must speak a little in detail : For the 
last three years I experienced a sort of tremor 
under mental agitation, whether such agitation 
be occasioned by ordinary business (I am a 
merchant) or by venereal feelings. This tremor 
is only occasional, but its recurrence is very 
frequent, especially of late. I am becoming 
less confident every day of my virile powers, 
for I find them much deteriorated. I have 
lived a bachelor up to my present time, have 
never been diseased with syphilis, and have 
now a very excellent opportunity of an extreme- 
ly good match with a young lady somewhat, 
nay, considerably younger than myself. One 
thing only deters me from marrying — debility 
of the genital organs, and premature emission 



KERVOUS EXHAUSTION. 161 

of semen. I have endeavored to make my case 
as open to you as possible. It is within your 
power, or the power of medicine, to restore me 
to anything like adequate strength to consum- 
mate the act of coition ? I am nervous — I am 
afraid. Write to me as soon as possible your 
opinion, and if you think medicine can relieve 
me, send it to me immediately. The occasion 
is urgent — that must plead my apology. I en- 
close fee. If you restore me to the state in 
which a husband is expected to be, I shall 
gladly acknowledge it, and remunerate you 
handsomely. Yours obediently, E. S. T." 

" Boston, Mass. 
" Dear Doctor — I have, I know, worried 
and teased you very much ; but you know too 
much of the wretched state of a man's mind, 
circumstanced as I was, till I consulted you, to 
feel annoyed at my unceasing importunities and 
interrogatories. I now find myself completely 
set to rights — everything as it should be — 
healthy and vigorous. I no longer feel any 
delicacy in undertaking the duties and respon- 
sibilities of a husband. From your assiduous 
and truly scientific directions and medicines, I 
am to be married in two or three days. Ought 
I not continue your last bottle a little longer ? 



162 NERVOUS EXHAUSTION. 

I enclose check, but I never can repay you for 
your kind indulgence to all my pettishness and 
over-anxieties. If of any service, you are at 
perfect liberty to publish the case — of course, 
omitting my name and address. 

"Ever your obliged, 

"B. S. T." 

Case 1,226. 
A gentleman of about thirty years of age, who 
was studying for the bar, consulted me in order 
to know if I thought it possible I could ever 
restore him to a vigorous state of health. He 
had, he said, when a boy, been taught the hor- 
rible habit of self-pollution by one of his 
father's stable lads, with whom he, boy-like, 
used to ramble about the stables and grounds, 
and this practice he had continued even long 
after both his judgment and his health had 
warned him to desist ; in fact, he told me he 
was ashamed to say that it was only by slow 
degrees that he had succeeded in obtaining the 
mastery of himself, and that he had only very 
recently been able completely and utterly to 
abstain. So firmly had the vice fixed itself 
upon him, that, even after he had made the 
strongest resolutions, the mere sight of anything 



KSBYOUS EXHAUSTION. 163 

in the least calculated to excite amatory feeling, 
or the reading of the most innocent paragraph 
in a newspaper or book, suggestive, even in the 
most remote way, of sexual enjoyment, was 
sufficient to scatter his good intentions to the 
winds, and cause him to seek the earliest oppor- 
tunity of solitarily gratifying his most odious 
propensity. While mentioning these and other 
circumstances with the utmost candor, he told 
me at the same time that no mere bodily suf- 
fering or ordinary consequences of his yicious- 
ness would have induced him to undergo the 
pain of thus unbosoming himself, and of mak- 
ing the disgraceful confession, were it not for 
two circumstances. One of these was, that un- 
less he could get absolutely cured, he was de- 
prived of all hope of his being able to succeed 
in his profession ; and the other, that having, 
for not less than seven years, been engaged to 
a young lady of great personal beauty and 
highly cultivated mind, between whom and 
himself the warmest attachment subsisted, the 
time was speedily approaching when either he 
must entirely debar himself her society, and 
leave her to imagine him (without power of 
explanation on his side) one of the basest and 
most insulting of men, or fix some period, 



164 NERVOUS EXHAUSTION. 

however remote, for their marriage, as the po- 
sition in life of both parties were such that no 
obstacle existed to their union. This he very 
properly declared he never would assent to 
while in his present condition — and a frightful 
condition it was. Although stout in body, his 
face was thin, hollow, and cadaverous ; his flesh 
was flabby, the scrotum was hanging loose, his 
limbs were weak, his hands unsteady and trem- 
bling, his breath waa so short that he dared not 
take even a short walk ; he had pains in his 
back and loins, besides a variety of other symp- 
toms. He found, moreover, that a gradual 
incapacity for study had for a long time been 
creeping over him, a confusion of ideas, an im- 
possibility of fixing his attention upon any sub- 
ject, and a constant state of wavering uncer- 
tainty, restlessness, and disquiet, the sure fore- 
running symptoms of mental imbecility. Un- 
der these circumstances he entreated my aid, if 
it was at all possible for that aid to be success- 
fully exerted. I undertook the case, and 
although the evils I had to eradicate were deep 
seated and of long standing, I at length, by 
perseverance and a careful study of his consti- 
tution and ailments, succeeded in effecting his 
restoration to a state of thorough health and 



KEKVOXJS EXHAUSTION. 165 

vigor. He has now been three } T ears married, 
has two children, and last year made a success- 
ful debut at the bar. 



Case 2,572. 
A gentleman, a large manufacturing chemist, 
called ujDon me early in May, 1862. He was 
suffering from a severe case of secondary symp- 
toms. About three months previously, after a 
casual connection, he had noticed chancres ; 
and having studied medicine, his business, too, 
giving him a first-rate knowledge of drugs, he 
thought he could soon cure himself. He there- 
fore began to take blue pills, with a lotion of 
sulphate of copper. He was slightly salivated, 
but the chancres healed, and he was delighted 
to find himself quite well. But, ten days be- 
fore seeing me, secondary symptoms broke out 
with the greatest virulence. His throat was 
severely attacked ; spots broke out all over his 
body ; his hair fell off (a common effect of 
mercury), and his constitution seemed com- 
pletely shattered. I also found, on careful 
examination and analysis of his urine, that he 
was suffering from spermatorrhoea — in fact 
there was a loss of seed every time he passed 
water. As was to be expected, the seed was 



166 NEKV0US EXHAUSTION. 

diseased ; in fact, syphilis had affected every 
tissue and secretion of the body. The case re- 
quired prompt treatment, and for three or four 
days the disease continued to make head against 
the medicine. However, I am happy to add 
that I soon controlled it, and in the course of 

seven weeks Mr. was perfectly restored to 

health and vigor. 



Case 2,596. 

Philadelphia. 
Captain M. A. , three months before consult- 
ing me, had observed a small pimple under the 
prepuce or foreskin, after a casual connection. 
Having rubbed it off, it was succeeded by 
another, rather larger, when, thinking it was 
"the heat of the body" he took mild aperient 
medicines. It remained stationary for some 
weeks, and then began to increase rapidly ; he 
also noticed a large swelling in each groin. 
Becoming alarmed, he determined, by the ad- 
vice of a friend, a brother officer, to consult 
me ; but, unfortunately, urgent business de- 
tained him some days longer. I immediately 
saw that the case was very serious ; the poison 
had acquired terrible virulence by remaining so 
long in the body, and, in spite of the most 



NERVOUS EXHAUSTION. 167 

powerful remedies, lie continued to get worse 
for some days. The chancres progressed so 
rapidly as to threaten the entire loss of the 
penis, and both buboes burst, leaving a large 
cavity in each groin. However, by the most 
energetic means, he was brought under the in- 
fluence of the medicines, and began to improve, 
though at first very slowly. This case required 
three months' constant attention before a cure 
was effected, and even then it was necessary to 
prescribe strengthening medicines for some 
weeks longer. I instance this case to prove the 
importance *of an early application in case of 
syphilis. Had the patient applied to me in the 
first instance, one week's attention would have 
been quite sufficient to insure a thorough cure, 
without pain or annoyance. I have lately re- 
ceived a letter from Captain M. A., stating that 
he is now thoroughly well, and as strong as 
ever. 



PICTURES FROM REAL LIFE. 



These are not intended to challenge criticism, 
nor to excite idle curiosity. Many may see 
them for whom they will have no interest — who 
may, perhaps, hardly understand them. They 
will, however, fall into the hands of some few 
who will thoroughly comprehend their purpose, 
and for whom they will have a solemn interest. 
They are, to those few, addressed in earnest 
solicitude, by one who desires to minister 
to their sorrows and to mitigate their 
infirmities. I ask, in good faith and kindness 
of heart, one favor from the person who may 
receive this copy. I beg of him to read it care- 
fully, thoroughly ; and if he finds in it nothing 
that has a personal application to him, to pre- 
sent it to some young man of his acquaintance. 
It may thus find a reader for whom it will have 
a peculiar personal interest. I entreat that 
reader to weigh my words calmly and delibe- 
rately, for on the decision of that present ten 
minutes will hang in all human probability, the 
happiness or misery of his future days. In that 



NERVOUS EXHAUSTION. 169 

time may be determined whether he shall live 
an ornament to society, an honor to his name, 
a healthy, happy man ; or whether he shall 
sink into the poor, pitiful, joyless, nerveless, 
prematurely old man, without heart, health, or 
hope. 



PICTURE FIRST I THE YOUNG SENSUALIST. 

14 The glory of a young man is his strength." 

In the great battle of life there is need that 
each combatant should have a brave heart and 
well-braced nerves, for the fight is long and 
arduous, and the weak and timid have no chance 
therein. Nor is the work all toil : the high 
endeavor — the end in view — makes of it a 
pleasure, and as we watch the busy passers-by 
in the broad thoroughfares of the city, every 
face seems eager and earnest. No, not every 
face. Here comes one, alone — a solitary one. 
He is young, but he has none of the busy char- 
acteristics of his fellow men. Listless in his 
manner, timid in his air, he wanders rather 
than walks through the crowded street. Maybe 
he is a clerk, or a student, or a mechanic. But 
why is he so vacant and so sad ? It is but three 
or four short years since, with a father's bless- 
ing and a mother's prayers, he went forth into 



170 NERVOUS EXHAUSTION. 

the world to conquer fortune, and " to make 
himself a man." Then his nerves were Arm, 
his mind was buoyant, his step was light, and 
his hopes were high. But these few short 
years have wrought a sad and fearful change. 
"JSTow neither hope nor ambition finds a place in 
his bosom. The fresh vigor of his youth is 
replaced by a weariness of life, even while his 
foot is yet but on its threshold. See how vacant 
and objectless is his gaze ! His hand wanders 
to his forehead, w T hich it feverishly presses, 
whilst a deep sigh escaping him tells of nervous 
exhaustion, and of a mind brooding over dark- 
ling thoughts. If you knew him as a child 
you are struck with the change. Then he was 
robust and stout ; now he is thin and pale. 
Then his eye would flash fire, as he dashed with 
energy into some boyish game ; now he turns 
aside from old companions, and frowns on what 
were once delights. And, hark ! that hectic 
cough that shakes his frame, exhausts* his 
breath, and tells of an undermined constitu- 
tion, and, perhaps, of the dread approach of 
consumption. Speak to him. What says he ? 
" He has been ill, and growing worse for a year 
or so. He cannot account for it, and the doc- 
tor does not seem to do him any good, or to 



NERVOUS EXHAUSTION. 171 

know what is the cause of his illness. His 
eyes are weak and his memory gets very bad." 
Poor fellow ! It is a sad tale. Is there n# 
solution ? Yes ; come with me. 

It is night time. He has retired to his bed. 
Let us lift the yeil of night, and gaze on him 
when he fondly fancies that no eye is upon him. 
Does he sleep the sleep of conscious rectitude — 
enjoy the welcome repose of a self-satisfied 
mind ? No, alas ! What tempest of passion — 
what hurricane of lust is this that sweeps across 
his soul ! Why do his strained eye-balls glare 
on vacancy ? Why does his cheek flush now 
like fire, now become pallid as death ? Why 
does his poor heart now beat as if it would 
burst through its tenement of flesh and bone, 
and anon scarce indicate a fitful pulse ? And 
now, why does he sink, sighing and exhausted, 
heljriess and almost lifeless on his pillow ? The 
fearful truth is all revealed. Sensuality has 
only too faithfully painted its deep lines on his 
body and mind. The picture is only too com- 
plete. Before you lies a poor, self-destroying, 
self-debauching, nerveless, joyless Onanist. 

" A shocking picture, indeed I" some of my 
readers exclaim, "but surely a little over- 
drawn ? " Not so. The silent tortures, the 



172 KERV0US EXHAUSTION 

voiceless sorrows endured by those who persist, 
from year to year, in the practice of Onanism 
exceed the descriptive power of my pen, or of 
any other. Instead of exaggerating, every true 
mind sinks appalled from the magnitude and 
sternness with which these evils haunt the foot- 
steps of those who persist in the practice, 
whether wilfully or ignorantly. The following 
description of his case was written to me some 
years ago by one who is now a happy husband 
and father : — 

" I was well and happy until the age of fif- 
teen, when I learnt the habit from a companion 
at school. To me it was like a new revelation, 
and my ardent temperament caused me to in- 
dulge to a fearful extent. As I became older a 
sentiment of shame withheld me to a certain 
extent ; but only three months ago, when I be- 
came possessed of your admirable book, did I 
entirely relinquish the habit. And now, through 
fatal ignorance, what have I become ? A 
wretched, nerveless invalid ; dreaming instead 
of working. My energies exhausted, my face 
pallid, my forehead covered with blotches, my 
appetite sometimes voracious and unnatural, 
end anon not to be tempted by the choicest 
viands. Pain, heavy pain, and deep languor 



KERVOUS EXHAUSTION. 173 

from morning till night. My eyeballs ache and 
throb ; I suffer acutely when I pass water : my 
groins seem weak, so that I cannot enjoy exer- 
cise. When it is morning, I long for the night; 
and then, what nights I pass ! Lascivious 
dreams disturb my rest ; my sleep is fitful and 
unrefreshing. Long hours I lie awake, fre- 
quently in a profuse perspiration, reflecting on 
my awful condition, and my thoughts em- 
bittered by the knowledge that surely my 'sin 
has found me out. 5 Oh ! sir, as you hope for 
blessings here and hereafter, exert your utmost 
skill to rescue from destruction a blighted 
wretch. v 

This is a picture drawn by the hand of a suf- 
ferer. A few short weeks more, perhaps, and 
his application to me would have been in vain. 
His constitution would have been utterly ruined. 

Again, had he applied to a general prac- 
titioner, who lacked the special opportunities I 
have now for thirty years enjoyed of studying 
the intricacies of these cases, he would probably 
long ago have been consigned to the grave, 
instead of surviving, as he does, in health, 
honor, and happiness. 



1*74 XERVOUS EXHAUSTION. 

PICTURE second: the bachelor sensualist. 

In every community there are many middle- 
aged men, who from choice or necessity have 
not assumed the responsibilities of married life. 
It may be they have failed to secure one whom 
they have fondly loved in youth ; it may be that 
they have determined to secure a higher position 
and a more assured income before marriage. 
As a general rule these men are hard-working, 
energetic men of business, strictly temperate, 
well educated, saving in their habits, and highly 
esteemed in society. But there are amongst 
them others altogether different — men of shy 
habits and downcast looks, sometimes of morose 
and peevish minds. In what should be the 
very prime of their life they find their consti- 
tutions failing them. They have well-grounded 
fears that manhood, vigor, mental and bodily, 
are fast leaving them. I have been consulted 
by many such. Their usual theme has been, 
" Why do I suffer ? Have I not led a sober, 
temperate, sensible life ? Have I ever been 
guilty of dissipation or debauchery ? My life 
has been regular ; I have kept early hours — 
lived in good, well-ventilated, cheerful homes ; 
my diet has been sound and wholesome, and I 



NERVOUS EXHAUSTION. 175 

have taken sufficient and regular exercise." All 
this is true. Every rule tending to health and 
happiness has been observed, save one. Under- 
stand, my friend, the blood is the life. Do 
you know that one ounce of the semen is equiva- 
lent to forty ounces of blood? Be no longer 
ignorant — you are answered. The secret sin— 
the sin of Onan— has been draining your heart's 
blood for years. Be assured that no man can 
commit evil without evil consequences — for 
" Sorrow tracketh wrong forever and ever." 

When the constitution is healthy and vigor- 
ous, it may resist the consequences for years ; 
but the ultimate effect will be all the more 
aggravated. The vital force, unable to bear 
the waste of more than life, gives way suddenly. 
The healthy middle-aged man becomes a con- 
firmed invalid. Worse — infinitely worse is it 
when such a man ignorantly marries. I re- 
member such a case. The gentleman was 
about forty years of age. He had gradually 
worked his way up (without canitai) trom the 
position of book-keeper, at a few shillings a 
week, to salesman, buyer, and ultimately part- 
ner in one of the greatest commercial houses in 
the city of G. This fact speaks volumes for 
his mental activity and unblemished integrity. 



176 KEKVOUS EXHAUSTION. 

He was a personable man, stout of limb, healthy 
in appearance, but a confirmed private sensua- 
list. Years had passed since he first addicted 
himself to the unfortunate habit — yet hitherto 
his system had resisted the constant drain upon 
its vital resources. Not that he has been with- 
out warnings. Sometimes a failing eye, a wan- 
dering mind, an unwilling stomach, perchance 
restless nights, and vague discomfort. He 
soothes his conscience, and says, " I work too 
hard, I have indigestion, I will take a holiday." 
And now he thinks it is time he should marry. 
His position is assured— he is a wealthy man — 
his ambition is satisfied, and he will seek to be 
happy. He is to all outward appearance an 
acceptable husband ; his character is beyond 
reproach. He only knows of one disreputable 
phase which disfigures it, and that he deter- 
mines to abandon forever, in order that he may 
be fit for the pure and virtuous embraces of his 
bride-elect. His sin has found him out ; those 
who will not be warned must be punished ; 
unhappily, too, the innocent must suffer also. 
He marries, and on the nuptial couch, in the 
arms of her he loves, he — poor self-deluded, 
self-ruined sensualist — discovers that the vigor 
of manhood has departed from him forever ! 



NERVOUS EXHAUSTION. 177 

PICTURE THIRD: THE MARRIED SENSUALIST. 

The sacred ordinance of marriage emanates 
from the Deity, by whom we are enjoined to 
"increase and multiply. 7 ' Hence it is con- 
sidered honorable amongst all men, and should 
not be entered upon carelessly or wantonly, nor 
without duly considering the causes for which 
it was originally ordained. A happy marriage 
is the bond of social purity, as it is the crown 
of domestic joys. But it frequently happens 
that young men injure themselves seriously — 
and even permanently — by the lengths to which, 
during the first year or two after marriage, they 
carry the indulgence — or, to speak more accu- 
rately, the coercion — of the sexual faculties. 
Those who have never had the advantage of 
friendly advice are apt to make serious mistakes 
as to the extent to which intercourse should 
take place. 

Let me warn the newly married couple of the 
dangers of excessive indulgence, which not only 
ruins the health, but soon renders intercourse 
utterly repugnant. In such a case, when the 
virile powers of the man fail him, and he no 
longer discharges with alarcity and effect the 
duties of a husband, the wife, not knowing 



178 NERVOUS EXHAUSTION. 

that she herself contributed to his impotency, 
but feeling a lack of warmth and vigor in his 
embrace — if not an absolute incapacity for 
sexual duties — begins to believe that it is else- 
where he seeks for gratification ; and jealousy 
and discord mar domestic peace. 

It is my solemn duty, therefore, to entreat 
those newly-married, who may have " o'er- 
stepped the modesty of nature," to pause ere 
the knell of all their mutual joys boom forth 
in the solemn words, " Too Late ! " — and to 
take steps to counteract the evils they have, 
perhaps unwittingly, invoked. Ten minutes' 
advice and instruction, added to skilful and 
mild treatment for two or three weeks, are 
often sufficient in these cases to restore tone to 
the debilitated organs, and renew, as it were, 
the bonds of love between husband and wife. 
The lesson, too, proves valuable, and is not 
often forgotten. 

But there is another and more frequent cause 
of matrimonial unhappiness — a cause to which 
I have already directed attention. 

Subjects of grave and painful importance re- 
quire plain and intelligible language. I will 
therefore say, emphatically, that the destruc- 
tive habit of self-abuse, practised in early life, 



XERV0VS EXHAUSTION. 179 

fearfully injures the energies concerned in the 
reproduction of our species, and the due fulfil- 
ment of the nuptial rite. And it unfortunately 
happens that a man may abandon self-abuse as 
a voluntary act, and yet not be free from the 
consequences of his former folly. A new and 
unnatural association has been established be- 
tween the organs of generation and the mind 
— involuntary discharges of semen take place 
during sleep ; the seed is lost in the urine, at 
stool ; and muscular fibres surrounding the 
seminal ducts become relaxed, and all control 
oyer their actions is entirely lost. Let not any, 
then, imagine that having incurred the judg- 
ment of guilt they shall wholly escape the 
penalty, unless by prudent and prompt action, 
and attention to skilled advice, the instant the 
knowledge of that guilt and the certainty of its 
fearful consequences occur to them, they adopt 
the only measures by which the scourge can be 
averted. Therefore let us solemnly warn any 
young man now contemplating marriage, and 
who may at times have indulged in the secret 
vice of the solitary sensualist, not to take upon 
himself the sacred obligations and responsi- 
bilities of a husband until he is fully satisfied 
that his blood, his nervous system, and his 



180 HERVOtTS EXHAtJSTIOK. 

procreative powers are free from the morbid 
effects of his past indulgence. 

PICTURE FOURTH : THE WIDOWER SENSUALIST. 

A man who could sit in my consulting room 
and listen day by day to the weary tales of sin 
and suffering, folly and remorse, which are 
continually poured into <my ear, without occa- 
sionally weeping with the sufferers, is a man 
whose sternness and stubbornness of heart I do 
not envy. For myself I do not blush to confess 
that during sucb confessions I am frequently 
compelled to give outward signs of my sym- 
pathy for the suffering narrator ; and the more 
I hear of those sufferings, the more I become 
conscious of the gross ignorance which pervades 
the medical faculty in regard to the character- 
istics and treatment of nervous and sexual dis- 
eases, the more devoted do I become to the 
specialty I have made of those diseases for the 
last thirty years, and the more determined is 
my resolution to persevere to the end in probing 
the very depths of scientific istudy and research, 
in order to conquer the difficulties attending 
the niagnosis of such disease, and render their 
successful treatment by me a series of profes- 
sional triumphs. 



HERVOUS EXSAITSTIOK. 181 

Of all the pitiable phases presented by the 
practice of self-abuse, none is so pitiable as 
that of the man who, having been bereft of the 
partner of his bed and home, abandons himself 
to the tyranny of self -lust, and thus precipi- 
tates himself into a dark and dismal gulf of 
bodily and mental affliction. 

Some time since, I was visited by a middle- 
aged man, who desired to consult me, and 
heard from him the following extraordinary 
statement : — 

He was a respectable tradesman, in business 
in Brooklyn. Twenty-seven months ago he had 
unfortunately lost his wife, to whom he was 
much attached. He had been married to her 
about fourteen years, and was left with a family 
of eight children. His circumstances were 
prosperous: he had a good business, and lived 
comfortably and well. He assured me most 
solemnly that during his wife's life he had 
never once been unfaithful to her. Shortly 
after her death, he began to feel himself moved 
by the passions of sexuality. He endeavored 
to resist the influence ; for having been faithful 
to his w T ife during life, he had resolved to honor 
her virtues and love by remaining faithful to 
her memory after death. Over and above which 



182 tfERVOUS EXHAUSTION. 

he had an utter abhorrence of the evils of pro- 
miscuous sexual intercourse ; and had also fully 
determined never to bring to his children a 
step-mother, who might probably — however 
careful his selection — prove anything but a 
second mother to them. His only hope, there- 
fore, was a resolution to resist the strong 
promptings of sexual desire. This he did for 
some time, but eventually, and unhappily, his 
resolution gave way, and in an evil moment he 
took to the practice of self-pollution. 

In this practice he found a means of ridding 
himself of the irritating sexual secretion ; and, 
totally unconscious of the danger to his health 
— nay, his very life — involved in the practice, 
he continued in unrestrained indulgence of the 
mad passion for a considerable time. 

Of late, however, he had felt his health and 
strength giving way ; his nights had become 
sleepless ; and he had almost constantly in- 
dulged in the practice in order to procure 
sleep. But the sleep resulting had at all times 
been feverish, fitful, and accompanied with 
dreams of the most unpleasant kind. 

He had also lost all relish for food — was ab- 
sent-minded and remiss in business, and felt 
that premature old age was fast creeping upon 



NERVOUS EXHAUSTION. * 183 

him. He had consulted his usual family doctor, 
who had attributed his ill-health to the indul- 
gence of silent grief for the loss of his wife, 
and to the worry and anxiety of an increasing 
business. Up to this time not a thought had 
ever crossed his mind that self-abuse was the 
cause of his misfortune. He happened, how- 
ever, to come across one of my works on "Ner- 
vous Debility," and reading it carefully, was at 
once struck w T ith the knowledge of the fact. 
He lost not an instant, but immediately leaving 
his house, hastened to consult me, and placed 
himself under treatment that very night. 

On examination, — and especially on making 
a careful analysis of his urine, — I found this 
patient very much debilitated, and the genera- 
tive organs functionally deranged. I also saw 
enough to be able to inform him, in the most 
positive manner, that if he persisted any#iir- 
ther in the practice of self-abuse, his nervous 
system would entirely break down, and the 
attributes of manhood be lost to him forever. 

Never was there a more docile patient. And, 
consequently, he was under treatment a very 
short time before he began to take heart. I 
could tell, by the increased buoyancy of his air 
every time he visited me, that he was in the 



184 NEBV0US EXHAUSTION. 

way of rapid improvement. He was all but 
restored to Lis former health. I induced him 
to substitute a regular and restrained habit and 
diet for his former free living ; and instead of 
his business being — as his former adviser told 
him — a source of misery and ill-health, he 
found in it a relief, and a healthy and pleasu- 
rable mode of maintaining the vigor and 
serenity of his mind and body. 

This is not a solitary case — many such have 
come under my observation ; and even now can 
I recall one which had not a termination so 
favorable. 

Argument and entreaty were alike without 
avail. The habit, relinquished for a week, was 
again and again indulged in. As the constitu- 
tion became more and more impaired, so the 
powers of the will decayed. Business and 
pleasure alike lost their hold on his memory, 
his thoughts or his appetite ; and a few short 
months saw him consigned — harmless enough, 
to be sure — to a private lunatic asylum, where 
he finished the miserable remnants of his days 
in the darkness and dimness and despair of a 
living death. 



NERVOUS EXHAUSTION. 185 

PICTURE FIFTH: THE SCEPTIC SENSUALIST. 

I can imagine one of my readers, who has 
glanced with rapid eye over the preceding pages, 
who may exclaim sotto voce, " Ay, ay, doctor ; 
it is all very well, and I dare say there are some 
two or three in a million to whom these facts 
and descriptions apply, but they apply to very 
few ! I believe that a man may practice self- 
abuse for years, and really suffer no evil conse- 
quences. I know that I have no time, no 
means, nor opportunity of indulging myself in 
the pleasures of a connubial life, and I have 
resorted to this habit to relieve myself of the 
promptings of nature, and I am neither sick 
nor diseased ; I have had none of the evils you 
speak of, and I don't think I ever shall.'' 

My reply is, " Gently, my friend ; do not 
draw rash conclusions. Listen patiently for a 
few minutes, and I think you will own yourself 
in the wrong." If you are an Onanist ; if you 
have at any time abandoned yourself to that 
vice, which has been aptly called "adultery of 
the mind/' 7" defy you to say truthfully that you 
have not experienced effects more or less evil. 
I challenge you, as an honest man, to say 
whether you have not had your warnings ? I 



186 NERVOUS EXHAUSTION. 

beg of you, specially you, sceptical reader, — 
infatuated abuser of yourself, — to answer to 
your own soul, in truth and sincerity, a few 
questions of solemn import touching the effects 
of self-abuse, not on another man, but on your- 
self — on your own precious body and mind. — 
Answer them truly, seriously, in the solitude of 
your own chamber, and think ere you reply. 

Are you an Onanist ? 

In pursuit of the baneful and degrading prac- 
tice of self-abuse, have you ever felt it to be a 
sinful practice — unmanly, unchristian, and de- 
grading you beneath the level of the brute 
beast, which in following the mere promptings 
of instinct never falls so low ? 

Have you ever yet once practised it without, 
in the very act, making up your mind that you 
would never repeat it ? 

Do you suffer from involuntary nocturnal 
emissions ? Are you ever troubled with erec- 
tions without apparent cause, failure of erection 
when desired, or premature discharge of semen 
during coition ? 

Have you dull pams in the groin, pains in 
the back ? Does your sight fail you ? Have 
you nervous headache ? 



HEBVOUS EXHAUSTION. 187 

Are you subject to pimples on the face, back, 
or forehead ? 

Do you suffer from a hacking cough, for 
which all remedies seem unavailing ? 

Are you fatigued with the slightest exertion, 
and does lassitude of body and mind overtake 
you without cause ? Are you restless when fa- 
tigued, and unable to obtain refreshing slumber? 

Have you lost energy, appetite, power of en- 
joyment ? Are you frequently averse to society, 
even of intimate friends ? bashful in female 
society, unable to join in conversation ? 

Does your memory fail you ? are all your 
senses blighted ? 

Do you fall into dreamy fits of abstraction, 
brooding over the past, hopeless as to the future 
— all the noble aspirations forgotten which 
gilded the morning of your career ? 

Honestly, thoughtfully, mournfully recalling 
your past life, are you not certain that your 
health would have been better, your heart 
stouter, your hopes brighter, your mind and 
thoughts purer, more dignified, and manly, if 
you had not acquired for yourself your own self- 
reproach ? 

Let the victim of his own evil passions answer 
these questions, among a thousand such as I 



188 NERVOUS EXHAUSTION. 

could propose to him. Answer them truly, 
honestly, and without mental reservation, as 
between Heaven and his own conscience. And 
if the answer to them, or any part of them, 
be the one emphatic " Yes," how will he dare 
to say that he has indulged his vile appetite for 
solitary excess without experiencing some of its 
attendant evils ? — without having had emphatic 
warning that his sin is finding him out, and 
that days and nights of woe and torture are 
now impending, unless he accepts the warning, 
and reverently retraces his steps from the evil 
path he has chosen ? 

Let him, therefore, earnestly endeavor to lead 
a new life, lest in the future day, as he has sown 
the storm so will he reap the whirlwind. When 
the tempest of passion and of lust shall have 
left him, bereft of all but an enfeebled mind, 
and a body racked — preyed upon by the tor- 
tures of a memory bitterer even than death. 

But I hope that many who read this will turn 
from their error, that truth will prevail, that their 
conscience will be awakened — alas! so many err 
through ignorance. And if this little book is in- 
strumental in saving even one who would other- 
wise have been lost, from evils leading to destruc- 
tion,! am amply rewarded — it has not been writ- 
ten in vain, 



KERV0US EXHAUSTION. 189 

PICTURE SIXTH: THE PROMISCUOUS SENSUALIST. 

Nearly four centuries ago, the swarthy sailors 
of Columbus, returning from the enterprise 
which added another hemisphere to the known 
world, brought with them that terrible plague 
which has since been one of the curses of civ- 
ilized life — 

SYPHILIS. 

It is not my intention to write at large on 
this subject ; for fuller information I must re- 
fer my readers to my work on " Nervous De- 
bility.' 5 

The most mysterious characteristics of this 
disease, and the most to be dreaded, is that by 
poisoning the blood and tissues, it entails misery 
years and years after the patient has been appa- 
rently cured. And not alone on himself — the 
poison being absorbed in the blood becomes 
hereditary, even to the third and fourth gene- 
rations. As much to be dreaded as the disease 
itself is the mercurial treatment almost univer- 
sally adopted by the general practitioner for its 
cure. I do not hesitate to assert that more 
carious bones, diseased brain, and shattered 
constitutions have been produced by the ex- 



190 NERVOUS EXHAUSTION. 

hibition of this poisonous mineral than by the 
disease itself. 

Let me in all cases earnestly advise any man 
suffering from disease not to attempt self-cure. 
Let him at once apply for assistance to one in 
whom he can place confidence — and more es- 
pecially to one who has made a specialty of 
these cases. It is not sound sense and reason, 
that one whose practice is devoted to a particu- 
lar complaint should better know how to cure 
than one who may see half-a-dozen cases by 
mere chance in twelve months ? One warning 
and I have done. A young man, having con- 
tracted a venereal taint in his single career, not 
knowing of any impediment, may marry, and 
innocently be the means of fastening upon his 
offspring manifold evils — and thus render his 
own and wife's, as well as their lives, an intole- 
rable misery and burden. This ought to be 
guarded against in every instance by a consul- 
tation, when marriage is contemplated. 



Notice to Patients and Invalid Readers. 



Dr. L. J. Kahn, having for many years ex- 
clusively devoted liis attention to the treatment 
of the diseases of the generative and ner- 
vous system described in the preceding pages, 
may be consulted personally from ten in the 
morning till two, and from five in the evening 
till eight, daily, at his permanent residence, 
51 East Tenth Street, between University 
Place and Broadway. 

The following directions are given to all who 
desire to consult Dr. Kahn : — 

1. The hours of consultation are from 10 A. M. till 2, and from 
5 to 8 P.M.; on Sundays till 2 P.M., at the Consulting Rooms, 
61 East Tenth Street, Xew York. 

2. Dr. Kahn's fee for consultation is $5. 

3. Dr. Kahn maybe consulted by letter; and 
patients at a distance are requested to be as 
minute as possible in describing the symptoms 
of their cases, age, habits, occupation, etc., 
and if any treatment has been previously 
adopted. Much of Dr. Kahn's practice is 
carried on by correspondence, and he has been 
successful in curing numerous cases which have 
been conducted by letter only. All letters 
must contain the consultation fee. 



192 NERVOUS EXHAUSTION. 

4. Dr. Kahn has made arrangements by which 
the necessary remedies can be forwarded, safely 
packed and free from observation, to all parts 
of the world ; and it is his invariable custom to 
destroy all correspondence, or to return it to the 
patient at the termination of each case. Pa- 
tients may have letters and packages forwarded 
by initials. The disclosures of a name is 
neither sought nor necessary ; the most perfect 
confidence may be relied on, so that no diffi- 
dence or timidity may prevent the application 
for professional relief. Patients are, however, 
requested to retain the same name or initials 
throughout the case, in order to prevent con- 
fusion. 

5. Dr. Kahn wishes to impress the impor- 
tance of one personal interview, even with pa- 
tients resident at a distance, more especially 
when it is necessary to make a microscopic or 
chemical analysis of the urine. In fact, this is 
of such importance that it would be advisable 
for those consulting him by letter to forward a 
small bottle per rail, carefully packed to prevent 
breakage (carriage paid), containing the urine 
passed in the morning. 

6. Dr.Kahn's permanent residence in N.Y. is: 

51 East Tenth Street, 
Bet. University Place and Broadway 



